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General NPI Number Information
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NPI Number | 1144403510
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Entity Type | Organization
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Legal Business Name | MAXINE DIXON-WILLIAMS
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Dates
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Enumeration Date | 12/08/2007
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Last Update Date | 12/08/2007
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Provider Practice Location Address
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Address Line | 54 LEE ST
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City | ROOSEVELT
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State | NY
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Zip | 11575-1024
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Country | US
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Telephone | 516-425-7654
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Fax |
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Provider Business Mailing Address
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Address Line | 54 LEE ST
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City | ROOSEVELT
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State | NY
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Zip | 11575-1024
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MS. MAXINE DIXON-WILLIAM
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Credential |
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Telephone | 516-425-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | NY
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