Individual
MS. ANDREA G WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1451 E 102ND ST, BROOKLYN, NY 11236-5509
(646) 387-4104
Mailing address
1451 E 102ND ST, BROOKLYN, NY 11236-5509
(646) 387-4104
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
673508
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC73918H
MEDICAID
NY
Enumeration date
09/30/2013
Last updated
09/30/2013
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