Individual
MARY S WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 FAIRFIELD DR, SENECA, PA 16346-2130
(814) 676-7843
(814) 676-7838
Mailing address
68 S. SERVICE RD., STE 350, MELVILLE, NY 11747-2358
(516) 945-3347
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN162685L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011861030003
—
PA
01
—
0015509530025
MEDICAID GROUP
PA
Enumeration date
11/29/2005
Last updated
04/27/2015
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