Provider Demographics
NPI:1528151750
Name:WILLIAMS, CHERYL E (PA)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:E
Other - Last Name:DALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3310 TIEMANN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2722
Mailing Address - Country:US
Mailing Address - Phone:718-231-7146
Mailing Address - Fax:718-920-4200
Practice Address - Street 1:MMC - DEPT. OF RADIOLOGY
Practice Address - Street 2:111 EAST 210TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007877363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant