Provider Demographics
NPI:1649567405
Name:WILLIAMS, DARLENE (RN)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 UNDERHILL AVE
Mailing Address - Street 2:205
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2752
Mailing Address - Country:US
Mailing Address - Phone:646-657-5763
Mailing Address - Fax:646-401-6939
Practice Address - Street 1:955 UNDERHILL AVE
Practice Address - Street 2:205
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2752
Practice Address - Country:US
Practice Address - Phone:646-657-5763
Practice Address - Fax:646-401-6939
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY561687163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse