Provider Demographics
NPI:1962190868
Name:KEBE, ADJI NGATHE
Entity type:Individual
Prefix:
First Name:ADJI
Middle Name:NGATHE
Last Name:KEBE
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 1:144 W 132ND ST BSMT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7817
Mailing Address - Country:US
Mailing Address - Phone:775-440-7268
Mailing Address - Fax:
Practice Address - Street 1:144 W 132ND ST BSMT 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7817
Practice Address - Country:US
Practice Address - Phone:775-440-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency