=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891056552
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CELINA J WILLIAMS-HAMLET FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2012
-----------------------------------------------------
Last Update Date | 05/30/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 45 LUDLOW ST SUITE 318
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10002-5453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-969-5555
-----------------------------------------------------
Fax | 914-969-5556
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 LUDLOW STREET. SUITE 318
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-969-5555
-----------------------------------------------------
Fax | 914-969-5556
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F3370551
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------