Provider Demographics
NPI:1598185076
Name:WILLIAMS, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
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 7
Mailing Address - Street 2:323 JAMES STREET
Mailing Address - City:CONNELLY
Mailing Address - State:NY
Mailing Address - Zip Code:12417-0007
Mailing Address - Country:US
Mailing Address - Phone:845-464-4081
Mailing Address - Fax:
Practice Address - Street 1:323 JAMES STREET
Practice Address - Street 2:BOX 7
Practice Address - City:CONNELLY
Practice Address - State:NY
Practice Address - Zip Code:12417
Practice Address - Country:US
Practice Address - Phone:845-464-4081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270265-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse