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NPI Code Detail

MEDICARE: TANISHIA WILLIAMS M.D.

MEDICARE: TANISHIA WILLIAMS M.D.
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
12080P0008XPediatric Neurodevelopmental Disabilities Physician25MA09380000NJ

General Provider Information

NPI Number : 1861625907
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANISHIA WILLIAMS M.D.
Provider Business Mailing Address
First Line : 3575 QUAKERBRIDGE RD
Second Line :
City : TRENTON
State : NJ
Zip : 08619-1271
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3575 QUAKERBRIDGE RD
Second Line :
City : TRENTON
State : NJ
Zip : 08619-1271
Country : US
Telephone Number : 732-258-7065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2009
Last Update Date : 12/10/2013

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