Individual
EVEREST L SMALL-WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
167 MORNINGSIDE DR, BRIDGEPORT, CT 06606-4619
(203) 522-5861
Mailing address
167 MORNINGSIDE DR, BRIDGEPORT, CT 06606-4619
(203) 522-5861
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
219265-1
NY
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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