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NPI Code Detail

MEDICARE: SEBASTIAN WILLIAMS

MEDICARE:   SEBASTIAN  WILLIAMS
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
1175T00000XPeer Specialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073151833
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEBASTIAN WILLIAMS
Provider Business Mailing Address
First Line : 11111 201ST ST
Second Line :
City : SAINT ALBANS
State : NY
Zip : 11412-2139
Country : US
Telephone Number : 718-807-7781
Fax Number :
Provider Business Practice Location Address
First Line : 2460 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5013
Country : US
Telephone Number : 718-807-7781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2019
Last Update Date : 09/30/2024

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Directions to “ SEBASTIAN WILLIAMS ” Practice Location

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