MEDICARE: SINCERE A 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	172A00000X	Driver	W4527817632222	FL

General Provider Information

NPI Number	:	1285947853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SINCERE A WILLIAMS

Provider Business Mailing Address
First Line	:	1535 UNIVERSITY BLVD
Second Line	:	SUITE 13C
City	:	BRONX
State	:	NY
Zip	:	10453-7511
Country	:	US
Telephone Number	:	347-615-0147
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 UNIVERSITY BLVD
Second Line	:	SUITE 13C
City	:	BRONX
State	:	NY
Zip	:	10453-7511
Country	:	US
Telephone Number	:	347-615-0147
Fax Number	:

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

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	07/23/2010

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