Provider Demographics
NPI:1124077631
Name:WILLIAMS, JOANNE E (RPA-C)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14303-0111
Mailing Address - Country:US
Mailing Address - Phone:716-298-8133
Mailing Address - Fax:716-298-8136
Practice Address - Street 1:6941 ELAINE DRIVE
Practice Address - Street 2:SUITE # 2
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304
Practice Address - Country:US
Practice Address - Phone:716-298-8133
Practice Address - Fax:716-298-8136
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006907363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006907OtherLICENCE
NYMW0409551OtherDEA
NYCC5333Medicare ID - Type UnspecifiedMCR