Provider Demographics
NPI:1912231986
Name:WILLIAMS, KRISTINE PATRICIA (DPT)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:PATRICIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 OLD WILLETS PATH
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4115
Mailing Address - Country:US
Mailing Address - Phone:631-232-5350
Mailing Address - Fax:631-232-1583
Practice Address - Street 1:611 OLD WILLETS PATH
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4115
Practice Address - Country:US
Practice Address - Phone:631-232-5350
Practice Address - Fax:631-232-1583
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist