Provider Demographics
NPI:1861481921
Name:WILLIAMS, CATHERINE LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LOUISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7785 N STATE ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-1229
Mailing Address - Country:US
Mailing Address - Phone:315-376-5287
Mailing Address - Fax:315-376-3228
Practice Address - Street 1:7785 N STATE ST
Practice Address - Street 2:SUITE 330
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-1229
Practice Address - Country:US
Practice Address - Phone:315-376-5287
Practice Address - Fax:315-376-3228
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1603191207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01178936Medicaid
NYB42924Medicare UPIN
NY52065CMedicare ID - Type UnspecifiedMEDICARE