MEDICARE: LONIA 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
1	374U00000X	Home Health Aide	54063601	PA

General Provider Information

NPI Number	:	1871200378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LONIA WILLIAMS

Provider Business Mailing Address
First Line	:	45 E CITY AVE UNIT 838
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-2421
Country	:	US
Telephone Number	:	888-955-4663
Fax Number	:	888-955-0563

Provider Business Practice Location Address
First Line	:	445 S 63RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-1039
Country	:	US
Telephone Number	:	267-579-7133
Fax Number	:	888-995-0563

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

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	11/03/2022

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Directions to “ LONIA WILLIAMS ” Practice Location

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