LISA SUSAN WILLIAMS


Address: 76 Southaven Ave Ste 5, Medford, NY 11763-3745
Phone: 6314478860

LISA SUSAN WILLIAMS (NPI# 1487216743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487216743
Entity Type Individual
Full Name LISA SUSAN WILLIAMS
Credential AGPCNP
Practice Address 76 Southaven Ave Ste 5
Medford
NY 11763-3745
Mailing Address 11 Wexford Dr
Oakdale
NY 11769-1438
Practice Telephone 6314478860
Mailing Telephone 5163805777
Enumeration Date 2019-07-07
Last Update Date 2019-07-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
309193 NY Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 76 SOUTHAVEN AVE STE 5
City MEDFORD
State NY
Zip Code 11763-3745

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1922592906 Elizabeth L Oakley Specialist 1 Sprat St, Medford, NY 11763 2018-06-21
1609383389 Federation of Organizations for The New York State Mentally Disabled Clinic/Center 3390 Route 112 Ste B, Medford, NY 11763 2018-01-04
1497109607 Tabitha Aitken Massage Therapist 28 Masem Ct, Medford, NY 11763 2016-04-14
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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Competitor

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City MEDFORD
Zip Code 11763

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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