Provider Demographics
NPI:1750309084
Name:WILLIAMS, NYASHA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:NYASHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6450
Mailing Address - Country:US
Mailing Address - Phone:212-316-7923
Mailing Address - Fax:212-316-7945
Practice Address - Street 1:781 OCEAN AVE APT 7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4915
Practice Address - Country:US
Practice Address - Phone:120-174-4457
Practice Address - Fax:201-744-4575
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY737983-01163WM0705X
NY080058-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY737983OtherREGISTERED PROFESSIONAL NURSE