Provider Demographics
NPI:1851397962
Name:WILLIAMS, KARYN (CRNA)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HIGHLAND PL
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4845
Mailing Address - Country:US
Mailing Address - Phone:973-736-3833
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHLAND PL
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4845
Practice Address - Country:US
Practice Address - Phone:973-736-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY413616367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0422AAMedicare ID - Type Unspecified
NY050090965Medicare ID - Type UnspecifiedRR