MEDICARE: MS. MELISSA DAWN 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
1	225X00000X	Occupational Therapist	015548	NY

General Provider Information

NPI Number	:	1336477710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA DAWN WILLIAMS OTR/L

Provider Business Mailing Address
First Line	:	55 NAGLE AVE APT 5G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-1421
Country	:	US
Telephone Number	:	347-891-3299
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 33RD ST STE 500
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2329
Country	:	US
Telephone Number	:	212-589-1215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/24/2009

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