Provider Demographics
NPI:1134364532
Name:KWANKAM, MAUREEN MARY YUNKAP (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MAUREEN MARY
Middle Name:YUNKAP
Last Name:KWANKAM
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:1650 SELWYN AVE APT 17E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7666
Mailing Address - Country:US
Mailing Address - Phone:781-420-9716
Mailing Address - Fax:
Practice Address - Street 1:1265 FULTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3401
Practice Address - Country:US
Practice Address - Phone:718-901-8294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-13
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY60263745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine