Provider Demographics
NPI:1528739018
Name:GRAHAM, JINMEE (ND, MPH)
Entity type:Individual
Prefix:DR
First Name:JINMEE
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:ND, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 RAVENSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1116
Mailing Address - Country:US
Mailing Address - Phone:914-319-9226
Mailing Address - Fax:
Practice Address - Street 1:6200 BALTIMORE AVE STE 300
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1054
Practice Address - Country:US
Practice Address - Phone:315-728-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDJ0000082175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath