Individual
KATHRYN ELIZABETH HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
117 MARYS AVE STE 101, KINGSTON, NY 12401-5849
(845) 339-1515
Mailing address
1061 STOLL CT, KINGSTON, NY 12401-1409
(910) 935-0036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
022184-1
NY
363AS0400X
Surgical Physician Assistant
Primary
022184
NY
Other
Enumeration date
07/17/2018
Last updated
07/08/2022
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