Provider Demographics
NPI:1437393253
Name:WILLIAMS, CINDY-ANNE CARLA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY-ANNE
Middle Name:CARLA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763-5 EASTERN PARKWAY
Mailing Address - Street 2:APT E-17
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213
Mailing Address - Country:US
Mailing Address - Phone:631-816-8054
Mailing Address - Fax:
Practice Address - Street 1:1052 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2913
Practice Address - Country:US
Practice Address - Phone:631-816-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY578668-1163WG0000X
PASP018573363LF0000X
NY342833363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily