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NPI Code Detail

MEDICARE: VINNIE DUNNELL WILLIAMS CRPA, CASAC-T

MEDICARE: VINNIE DUNNELL WILLIAMS CRPA, CASAC-T
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 SpecialistNY
2101YA0400XAddiction (Substance Use Disorder) Counselor34398NY

General Provider Information

NPI Number : 1467011320
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINNIE DUNNELL WILLIAMS CRPA, CASAC-T
Provider Business Mailing Address
First Line : 11 HONEY BUNCH LN
Second Line :
City : ROCHESTER
State : NY
Zip : 14609-1650
Country : US
Telephone Number : 585-532-0979
Fax Number :
Provider Business Practice Location Address
First Line : 72 HINCHEY RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14624-2930
Country : US
Telephone Number : 585-627-1777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2019
Last Update Date : 10/05/2022

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