Provider Demographics
NPI:1053993998
Name:WILLIAMS, GERALDINE A
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 ELY PL SE APT 230
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3037
Mailing Address - Country:US
Mailing Address - Phone:202-415-6710
Mailing Address - Fax:
Practice Address - Street 1:1507 BENNING RD NE APT D13
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4595
Practice Address - Country:US
Practice Address - Phone:202-749-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant