Provider Demographics
NPI:1619147766
Name:WILLIAMS, CATHERINE C (RN, NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BARBARA ANN ST
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-3000
Mailing Address - Country:US
Mailing Address - Phone:631-878-6008
Mailing Address - Fax:
Practice Address - Street 1:99 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2821
Practice Address - Country:US
Practice Address - Phone:631-281-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY423813-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool