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General NPI Number Information
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NPI Number | 1447210968
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH MOLLOY PA
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 475 SEAVIEW AVE STATEN ISLAND UNIVERSITY HOSPITAL
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3498
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Country | US
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Telephone | 718-226-1608
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Fax | 718-226-1633
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Provider Business Mailing Address
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Address Line | 21 DANIELLE WAY
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1819
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Country | US
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Telephone | 732-591-2180
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001983
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License Number State | NY
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