Provider Demographics
NPI:1518535418
Name:CAMPBELL WILLIAMS, KAYAN ANTOINETTE MAUREEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:KAYAN
Middle Name:ANTOINETTE MAUREEN
Last Name:CAMPBELL WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-01 BROADWAY RM C10-12
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-3542
Mailing Address - Fax:718-334-3441
Practice Address - Street 1:79-01 BROADWAY RM C10-12
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-3542
Practice Address - Fax:718-334-3441
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program