| Doctor Name: | MR. EDWARD A WILLIAMS |
| NPI Number: | 1114252715 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NURSE PRACTITIONER |
| License Number: | F-401226-1 |
| Business Practice Address: | 6110 Queens Blvd 2nd Floor Woodside, NY - 113775776 |
| Business Phone Number: | 7183972002 |
| Business Fax Number: | 6465248323 |
| Mailing Address: | 123 Mermaid Ln, Unit 242 BRONX |
| State: | NY |
| Postal Code: | 104732499 |
| Phone Number: | 7186841832 |
| Fax Number: | |
| NPI Enumeration Date: | 10/15/2009 |
| NPI Last Update Date: | 01/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | F-401226-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |