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NPI Code Detail

MEDICARE: KHALILAH WILLIAMS-PERRY FNP-BC

MEDICARE: KHALILAH WILLIAMS-PERRY FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner344735NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932748746
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHALILAH WILLIAMS-PERRY FNP-BC
Provider Business Mailing Address
First Line : 707 E MAIN ST
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-2650
Country : US
Telephone Number : 845-333-7575
Fax Number : 845-333-7139
Provider Business Practice Location Address
First Line : 2817 ALBANY POST RD
Second Line :
City : MONTGOMERY
State : NY
Zip : 12549-2132
Country : US
Telephone Number : 845-457-3155
Fax Number : 845-457-9036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2019
Last Update Date : 05/16/2022

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