Healthcare Provider Details

I. General information

NPI: 1376466383
Provider Name (Legal Business Name): YASHMEYK WILLIAMSON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVE
NEW YORK NY
10037-1889
US

IV. Provider business mailing address

506 LENOX AVE
NEW YORK NY
10037-1889
US

V. Phone/Fax

Practice location:
  • Phone: 844-692-4692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035479-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: