MEDICARE: MS. GWENDOLINE WARNER WILLIAMS L.AC.

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	171100000X	Acupuncturist	1752	NY

General Provider Information

NPI Number	:	1669685616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GWENDOLINE WARNER WILLIAMS L.AC.

Provider Business Mailing Address
First Line	:	1199 PARK AVE
Second Line	:	APT 1J
City	:	NEW YORK
State	:	NY
Zip	:	10128-1711
Country	:	US
Telephone Number	:	917-566-5477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1199 PARK AVENUE
Second Line	:	APT 1J
City	:	NEW YORK
State	:	NY
Zip	:	10128-1711
Country	:	US
Telephone Number	:	917-566-5477
Fax Number	:

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	09/02/2016

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