Healthcare Provider Details

I. General information

NPI: 1861869950
Provider Name (Legal Business Name): ASHLEY WILLIAMS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CORNELIA ST STE 303
PLATTSBURGH NY
12901-2318
US

IV. Provider business mailing address

210 CORNELIA ST STE 303
PLATTSBURGH NY
12901-2318
US

V. Phone/Fax

Practice location:
  • Phone: 518-314-3460
  • Fax: 518-314-3464
Mailing address:
  • Phone: 518-314-3460
  • Fax: 518-314-3464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0550031659
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number018773
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: