Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F305003 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | F305003 | NY |
NPI | 1043440977 |
---|---|
Provider Name | Carolyn L Wray-Williams |
First Address | New York, NY 10016-6401 |
Second Address | New York, NY 10016-6401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2009 |
Last Update Date | 18/01/2012 |