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NPI Code Detail

MEDICARE: JASON PAUL WILLIAMS

MEDICARE: JASON PAUL WILLIAMS
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
1224Z00000XOccupational Therapy Assistant6196CA

General Provider Information

NPI Number : 1528574936
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON PAUL WILLIAMS
Provider Business Mailing Address
First Line : 12 MARILYN DR
Second Line :
City : GLENVILLE
State : NY
Zip : 12302-3806
Country : US
Telephone Number : 619-459-8778
Fax Number :
Provider Business Practice Location Address
First Line : 10B MADISON AVENUE EXT
Second Line :
City : ALBANY
State : NY
Zip : 12203-7314
Country : US
Telephone Number : 518-867-3061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2017
Last Update Date : 07/25/2025

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