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NPI Code Detail

MEDICARE: TRACEY WILLIAMS RPH

MEDICARE: TRACEY WILLIAMS RPH
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
1183500000XPharmacist042237NY

General Provider Information

NPI Number : 1215259478
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY WILLIAMS RPH
Provider Business Mailing Address
First Line : 687 9TH AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10036-3630
Country : US
Telephone Number : 212-246-8169
Fax Number : 212-265-7364
Provider Business Practice Location Address
First Line : 687 9TH AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10036-3630
Country : US
Telephone Number : 212-246-8169
Fax Number : 212-265-7364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2010
Last Update Date : 02/15/2010

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