Individual
DOMIQUE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, WHNP
Contact information
Practice address
105 STEVENS AVE, SUITE 506, MOUNT VERNON, NY 10550-2686
(914) 665-2229
Mailing address
105 STEVENS AVENUE, SUITE 506, MOUNT VERNON, NY 10550
(914) 665-2229
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
607735-1
NY
Other
Enumeration date
08/17/2016
Last updated
04/20/2017
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