MEDICARE: JILL M WILLIAMS MD

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	2084P0802X	Addiction Psychiatry Physician	MA65470	NJ
2	2084P0800X	Psychiatry Physician	25MA06547000	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1366542565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL M WILLIAMS MD

Provider Business Mailing Address
First Line	:	66 W GILBERT ST
Second Line	:	2ND FLOOR
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4947
Country	:	US
Telephone Number	:	732-212-0051
Fax Number	:	732-212-0713

Provider Business Practice Location Address
First Line	:	671 HOES LN
Second Line	:	D339
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-5627
Country	:	US
Telephone Number	:	732-235-4341
Fax Number	:	732-235-4277

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/04/2011

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