Provider Demographics
NPI:1033409263
Name:WILLIAMS, RAFEEQA SAKEENA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:RAFEEQA
Middle Name:SAKEENA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 MANSION ST
Mailing Address - Street 2:1ST FL
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3501
Mailing Address - Country:US
Mailing Address - Phone:845-784-7079
Mailing Address - Fax:
Practice Address - Street 1:365 MANSION ST
Practice Address - Street 2:1ST FL
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3501
Practice Address - Country:US
Practice Address - Phone:845-784-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305109-1164W00000X
NY738578-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty