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NPI Code Detail

MEDICARE: SHANIQUE WILLIAMS OTR/L

MEDICARE:   SHANIQUE  WILLIAMS  OTR/L
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1285270058
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANIQUE WILLIAMS OTR/L
Provider Business Mailing Address
First Line : 1595 JAMES AVE
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-1300
Country : US
Telephone Number : 347-271-2555
Fax Number :
Provider Business Practice Location Address
First Line : 3425 82ND ST
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-2967
Country : US
Telephone Number : 718-898-6973
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2019
Last Update Date : 11/26/2019

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Directions to “ SHANIQUE WILLIAMS OTR/L” Practice Location

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