Provider Demographics
NPI:1750643854
Name:WILLIAMS, ELIZABETH KATHLEEN (MASTERS)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KATHLEEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:KATHLEEN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASTERS OF SCIENCE
Mailing Address - Street 1:245 REMSEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-1351
Mailing Address - Country:US
Mailing Address - Phone:347-405-6702
Mailing Address - Fax:
Practice Address - Street 1:111 LIVINGSTON ST STE 101
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5078
Practice Address - Country:US
Practice Address - Phone:718-625-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY871666174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist