Basic Information
| Provider Information | |||||||||
| NPI: | 1710151394 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | DARYL | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 INGRID RD | ||||||||
| Address2: | |||||||||
| City: | SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117332217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312411224 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | STONY BROOK UNIVERISTY HOSPITAL EM | ||||||||
| Address2: | HSC LEVEL 4 ROOM 080 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442754 | ||||||||
| FaxNumber: | 6314446031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2008 | ||||||||
| LastUpdateDate: | 08/30/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 2009-00811 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 270099-1 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.