Individual
ANDREA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
998 CROOKED HILL RD, WEST BRENTWOOD, NY 11717-1019
(631) 761-3540
Mailing address
841 PROVOST AVE, BELLPORT, NY 11713-1532
(631) 918-0045
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305588
NY
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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