Healthcare Provider Details

I. General information

NPI: 1326942475
Provider Name (Legal Business Name): JAMARUS WILLIAMS LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4718 DEWEY AVE APT 4
ROCHESTER NY
14612-2432
US

IV. Provider business mailing address

4718 DEWEY AVE APT 4
ROCHESTER NY
14612-2432
US

V. Phone/Fax

Practice location:
  • Phone: 585-300-1944
  • Fax:
Mailing address:
  • Phone: 585-300-1944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number346901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: