Provider Demographics
NPI:1427530658
Name:WILLIAMS, SANDY (APN)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 CAMPUS DRIVE 4TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-8021
Mailing Address - Country:US
Mailing Address - Phone:732-937-8939
Mailing Address - Fax:732-418-8372
Practice Address - Street 1:110 REHILL AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-8021
Practice Address - Country:US
Practice Address - Phone:908-685-2200
Practice Address - Fax:732-923-2272
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01375600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health