Healthcare Provider Details

I. General information

NPI: 1245328335
Provider Name (Legal Business Name): NANCY MONESTIME-WILLIAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 QUINNIPIAC AVE
NEW HAVEN CT
06513-4003
US

IV. Provider business mailing address

646 QUINNIPIAC AVE
NEW HAVEN CT
06513-4003
US

V. Phone/Fax

Practice location:
  • Phone: 203-745-5505
  • Fax:
Mailing address:
  • Phone: 203-745-5505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL27080
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: