Provider Demographics
NPI:1659585388
Name:KOKAYI, KAMAU BANDELE (MD)
Entity Type:Individual
Prefix:
First Name:KAMAU
Middle Name:BANDELE
Last Name:KOKAYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3055
Mailing Address - Country:US
Mailing Address - Phone:212-792-6010
Mailing Address - Fax:212-792-6020
Practice Address - Street 1:41 EASTERN PKWY STE 1B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238
Practice Address - Country:US
Practice Address - Phone:718-622-2042
Practice Address - Fax:347-342-3962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155241208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice