Provider Demographics
NPI:1639618846
Name:WILLIAMS, KARLY
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLY
Other - Middle Name:
Other - Last Name:CAYARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:24 OAKLAND PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5008
Mailing Address - Country:US
Mailing Address - Phone:718-930-4550
Mailing Address - Fax:
Practice Address - Street 1:24 OAKLAND PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-5008
Practice Address - Country:US
Practice Address - Phone:718-930-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31066045164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse