Individual
KELLY WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
329 N SALINA ST, SYRACUSE, NY 13203-1755
(315) 471-1564
Mailing address
108 TERRACE CIR, SYRACUSE, NY 13214-1232
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
021455
NY
Other
Enumeration date
10/05/2017
Last updated
01/09/2025
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