Provider Demographics
NPI:1073097960
Name:WILLIAMS, BREANUA JANAI (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:BREANUA
Middle Name:JANAI
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BUFFALO HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-5471
Mailing Address - Country:US
Mailing Address - Phone:732-764-0232
Mailing Address - Fax:
Practice Address - Street 1:1465 NJ-31
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801
Practice Address - Country:US
Practice Address - Phone:908-735-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01820700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist