Provider Demographics
NPI:1811010077
Name:CATHERINE M MC WILLIAMS
Entity Type:Organization
Organization Name:CATHERINE M MC WILLIAMS
Other - Org Name:FAIRFAX PHYSICAL THERAPY & FITNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:WEICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-861-0862
Mailing Address - Street 1:201 E 69TH ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5471
Mailing Address - Country:US
Mailing Address - Phone:212-861-0862
Mailing Address - Fax:212-744-0383
Practice Address - Street 1:201 E 69TH ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5471
Practice Address - Country:US
Practice Address - Phone:212-861-0862
Practice Address - Fax:212-744-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007325-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty