MEDICARE: DR. DANIEL T 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	2084P0804X	Child & Adolescent Psychiatry Physician	107547	NY

General Provider Information

NPI Number	:	1811094451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL T WILLIAMS MD

Provider Business Mailing Address
First Line	:	21 MEADOW WOODS RD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11020-1231
Country	:	US
Telephone Number	:	516-488-3636
Fax Number	:	516-482-5532

Provider Business Practice Location Address
First Line	:	2001 MARCUS AVE.
Second Line	:	SUITE 218 NORTH
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042
Country	:	US
Telephone Number	:	516-488-3636
Fax Number	:	516-270-3939

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

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	05/28/2014

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