Provider Demographics
NPI:1508471871
Name:WILLIAMS, KAREN (LAC, DACM, DIPL OM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LAC, DACM, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:NY
Mailing Address - Zip Code:12121-2522
Mailing Address - Country:US
Mailing Address - Phone:518-570-9290
Mailing Address - Fax:
Practice Address - Street 1:2965 RIVER RD
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:NY
Practice Address - Zip Code:12121-2522
Practice Address - Country:US
Practice Address - Phone:518-570-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006641171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist