Healthcare Provider Details

I. General information

NPI: 1194658740
Provider Name (Legal Business Name): MR. HASSAN JIHAD WILLIAMSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 WILKINSON AVE
BRONX NY
10461-4004
US

IV. Provider business mailing address

650 LENOX AVE APT 9H
NEW YORK NY
10037-1035
US

V. Phone/Fax

Practice location:
  • Phone: 347-621-2185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131117
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: