Healthcare Provider Details

I. General information

NPI: 1831017946
Provider Name (Legal Business Name): PAIGE LEA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 GRAHAM RD W
ITHACA NY
14850-1055
US

IV. Provider business mailing address

71 W MAIN ST
DRYDEN NY
13053-8706
US

V. Phone/Fax

Practice location:
  • Phone: 607-257-2188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number359938
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: