Individual
MR. KENROY L CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-5000
(718) 240-6583
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-5000
(718) 240-6583
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
011789
NY
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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