Healthcare Provider Details

I. General information

NPI: 1619147766
Provider Name (Legal Business Name): CATHERINE C. WILLIAMS RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 LEXINGTON RD
SHIRLEY NY
11967-2821
US

IV. Provider business mailing address

16 BARBARA ANN ST
MANORVILLE NY
11949-3000
US

V. Phone/Fax

Practice location:
  • Phone: 631-281-6800
  • Fax:
Mailing address:
  • Phone: 631-878-6008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number423813-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: