Provider Demographics
NPI:1659036044
Name:WILLIAMS, WEDNESDAY A (NP)
Entity type:Individual
Prefix:MS
First Name:WEDNESDAY
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2298
Mailing Address - Country:US
Mailing Address - Phone:646-430-4490
Mailing Address - Fax:
Practice Address - Street 1:150 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2298
Practice Address - Country:US
Practice Address - Phone:646-430-4490
Practice Address - Fax:718-747-9696
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY310550363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health