MEDICARE: FELICIA C WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle	111165134	NY
2	344600000X	Taxi	111165134	NY

General Provider Information

NPI Number	:	1144794900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA C WILLIAMS

Provider Business Mailing Address
First Line	:	490 NIAGARA ST STE 3
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-1741
Country	:	US
Telephone Number	:	716-936-1953
Fax Number	:

Provider Business Practice Location Address
First Line	:	490 NIAGARA ST STE 3
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-1741
Country	:	US
Telephone Number	:	716-936-1953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	01/15/2019

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Directions to “ FELICIA C WILLIAMS ” Practice Location

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