Derek JRW Williams, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005384-1 Issued in NY

Practice address

320 E 94TH St FL 2
Mount Sinai Adolescent Health Center
New York, NY 10128-5604

Phone

(212) 731-7530

Fax

(212) 423-2920

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922107085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 BROADWAY",
            "address_2": "SUITE 601",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333726",
            "telephone_number": "347-789-7556",
            "fax_number": "419-858-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E 94TH ST FL 2",
            "address_2": "MOUNT SINAI ADOLESCENT HEALTH CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285604",
            "telephone_number": "212-731-7530",
            "fax_number": "212-423-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEREK",
        "middle_name": "JRW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005384-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Williams, MD
• Deborah Williams
• Deborah Ann Williams, LCSW
• Denise Heller Williams, LMT
• Denzel Williams
• Desiree G Williams
• Divine Williams, LMHC
• Dominic Williams
• Dominique Ann Williams, MA, MA, PD
• Donna R Williams, DDS

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.