Provider Demographics
NPI:1336856970
Name:WILLIAMS, ERICA RENEE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:PROF
Other - First Name:ERICA
Other - Middle Name:RENEE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:300 PIERMONT AVE APT 3G
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4654
Mailing Address - Country:US
Mailing Address - Phone:914-409-6259
Mailing Address - Fax:
Practice Address - Street 1:300 PIERMONT AVE APT 3G
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-4654
Practice Address - Country:US
Practice Address - Phone:914-409-6259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381966208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics