Provider Demographics
NPI:1740234574
Name:WILLIAMS, ISMEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMEE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 BROADWAY
Mailing Address - Street 2:COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:221-304-7250
Mailing Address - Fax:212-544-1974
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:221-304-7250
Practice Address - Fax:212-544-1974
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2178962080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0101681Medicaid
NY02739754Medicaid
NJ0101681Medicaid