Healthcare Provider Details

I. General information

NPI: 1396229878
Provider Name (Legal Business Name): KATHERINE LEIGH WILLIAMS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

523 GRAND ST
NEW YORK NY
10002-4103
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-1500
  • Fax:
Mailing address:
  • Phone: 804-382-2826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number043517
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: