Provider Demographics
NPI:1326786286
Name:GRANT, AKEEM VICTOR (RN)
Entity Type:Individual
Prefix:
First Name:AKEEM
Middle Name:VICTOR
Last Name:GRANT
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:877 EMPIRE BLVD APT D3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-5756
Mailing Address - Country:US
Mailing Address - Phone:347-251-8653
Mailing Address - Fax:
Practice Address - Street 1:241 NORTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1154
Practice Address - Country:US
Practice Address - Phone:914-293-5001
Practice Address - Fax:877-579-8823
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-21
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY721410163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology