Provider Demographics
NPI:1225481674
Name:WILLIAMS, EURYDICE
Entity Type:Individual
Prefix:
First Name:EURYDICE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E JERSEY ST
Mailing Address - Street 2:# 201
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07206-1375
Mailing Address - Country:US
Mailing Address - Phone:908-838-2812
Mailing Address - Fax:
Practice Address - Street 1:418 E JERSEY ST
Practice Address - Street 2:# 201
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07206-1375
Practice Address - Country:US
Practice Address - Phone:908-838-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325967164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse