Keisha Grannum

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0189291 Issued in NY

Practice address

10434 210TH St
Queens Village, NY 11429-1420

Phone

(347) 678-1488

NPI assigned

Sep 30, 2009

Last updated

Sep 30, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1245564897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10434 210TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10434 210TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291420",
            "telephone_number": "347-678-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANNUM",
        "first_name": "KEISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0189291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jini Gopinathan, RPH
• Karen Gordon, PSY.D.
• Elizabeth Gormezano
• Joanne Marie Gornail
• Julie Gottlieb, OTR/L
• Carey D Gray
• Malikah Gray, RN
• Christine Greaves
• Deborah J Greene
• Lester Greene, RPH

• Speech-Language Pathologist in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.