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General NPI Number Information
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NPI Number | 1275424814
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Entity Type | Individual
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Provider Name | KEMONIE N WILLIAMS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 754 CLINTON AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-2369
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Country | US
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Telephone | 203-923-2204
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Fax |
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Provider Business Mailing Address
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Address Line | 6134 AVALON GATES
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City | TRUMBULL
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State | CT
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Zip | 06611-5819
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Country | US
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Telephone | 860-380-7458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | CT
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