Provider Demographics
NPI:1164955506
Name:LEE, KATHRYN WILLIAMS (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:WILLIAMS
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1375 WASHINGTON AVE STE 227
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1065
Mailing Address - Country:US
Mailing Address - Phone:518-465-7172
Mailing Address - Fax:
Practice Address - Street 1:1375 WASHINGTON AVE STE 227
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1065
Practice Address - Country:US
Practice Address - Phone:518-465-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300381207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty