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NPI Code Detail

MEDICARE: MICHELLE NICOLE WILLIAMS M.D.

MEDICARE: MICHELLE NICOLE WILLIAMS M.D.
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
12084P0800XPsychiatry PhysicianQ6129TX
22084N0400XNeurology Physician235672NY

General Provider Information

NPI Number : 1013120849
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE NICOLE WILLIAMS M.D.
Provider Business Mailing Address
First Line : 1 LARKIN PLZ APT 205
Second Line :
City : YONKERS
State : NY
Zip : 10701-2873
Country : US
Telephone Number : 929-348-4442
Fax Number :
Provider Business Practice Location Address
First Line : 3050 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10467-8124
Country : US
Telephone Number : 718-944-7115
Fax Number : 718-944-7091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 01/29/2019

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