Provider Demographics
NPI:1093467425
Name:WILLIAMS, VIKKI (NYCPS)
Entity Type:Individual
Prefix:
First Name:VIKKI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NYCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXECUTIVE HOUSE APTS
Mailing Address - Street 2:175 S. SWAN STREET- 9F
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 S. PEARL STREET F
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202
Practice Address - Country:US
Practice Address - Phone:518-447-4555
Practice Address - Fax:518-447-4661
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist