Provider Demographics
NPI:1649665720
Name:KEMOH, JOHNETTA MASSAH
Entity type:Individual
Prefix:
First Name:JOHNETTA
Middle Name:MASSAH
Last Name:KEMOH
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 1:81 HAMILTON AVE
Mailing Address - Street 2:APT #2 FLOOR
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-8105
Mailing Address - Country:US
Mailing Address - Phone:914-882-5266
Mailing Address - Fax:
Practice Address - Street 1:1133 WESTCHESTER AVE
Practice Address - Street 2:SUITE N 230
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-3516
Practice Address - Country:US
Practice Address - Phone:914-576-5292
Practice Address - Fax:914-576-3983
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-05
Last Update Date:2015-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator