Provider Demographics
NPI:1710362231
Name:JEREMIAH-KING, RHONISHA
Entity Type:Individual
Prefix:
First Name:RHONISHA
Middle Name:
Last Name:JEREMIAH-KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 E 92ND ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-1434
Mailing Address - Country:US
Mailing Address - Phone:646-409-1688
Mailing Address - Fax:
Practice Address - Street 1:237 E 92ND ST APT 1F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-1434
Practice Address - Country:US
Practice Address - Phone:646-409-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities