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General NPI Number Information
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NPI Number | 1114252715
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Entity Type | Individual
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Provider Name | EDWARD A WILLIAMS NURSE PRACTITIONER
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Gender | Male
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 6110 QUEENS BLVD 2ND FLOOR
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City | WOODSIDE
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State | NY
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Zip | 11377-5776
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Country | US
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Telephone | 718-397-2002
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Fax | 646-524-8323
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Provider Business Mailing Address
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Address Line | 123 MERMAID LN UNIT 242
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City | BRONX
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State | NY
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Zip | 10473-2499
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Country | US
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Telephone | 718-684-1832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401226
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 576387
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License Number State | NY
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