Provider Demographics
NPI:1801171913
Name:WILLIAMS, QUYEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:QUYEN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3112 VESTAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2038
Mailing Address - Country:US
Mailing Address - Phone:607-729-6204
Mailing Address - Fax:
Practice Address - Street 1:3112 VESTAL PKWY E
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-2038
Practice Address - Country:US
Practice Address - Phone:607-729-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026265183500000X
TX44339183500000X
CA65135183500000X
NYI-061463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist