Provider Demographics
NPI:1194335174
Name:KROMAH, KALILOU
Entity type:Individual
Prefix:MR
First Name:KALILOU
Middle Name:
Last Name:KROMAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064 SHERIDAN AVENUE APT # 1D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456
Mailing Address - Country:US
Mailing Address - Phone:917-463-8729
Mailing Address - Fax:
Practice Address - Street 1:1064 SHERIDAN AVENUE APT # 1D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456
Practice Address - Country:US
Practice Address - Phone:917-463-8729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4039872084P0800X
NY646942163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry