Provider Demographics
NPI:1477921534
Name:WILLIAMS, CATHERINE D
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
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 1:1861 GRAND AVE
Mailing Address - Street 2:UNIT A5
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2400
Mailing Address - Country:US
Mailing Address - Phone:516-459-5266
Mailing Address - Fax:516-608-5477
Practice Address - Street 1:1861 GRAND AVE APT A5
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2412
Practice Address - Country:US
Practice Address - Phone:516-459-5266
Practice Address - Fax:516-608-5477
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-07
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322793163WC0400X, 163WD1100X, 163WH0200X, 163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY322793OtherRN LICENSE #