Healthcare Provider Details

I. General information

NPI: 1326942988
Provider Name (Legal Business Name): T'KEYAH ANTOINETTE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CLARKSON AVE
BROOKLYN NY
11203-2012
US

IV. Provider business mailing address

366 BROADWAY
AMITYVILLE NY
11701-2784
US

V. Phone/Fax

Practice location:
  • Phone: 718-270-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number384022
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: