Provider Demographics
NPI:1073607883
Name:ANDREWS, WILLIAM HOLSTON (LICENSED CERTIFIED S)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:HOLSTON
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:LICENSED CERTIFIED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 EAST 90TH STREET
Mailing Address - Street 2:2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4246
Mailing Address - Country:US
Mailing Address - Phone:212-996-0518
Mailing Address - Fax:
Practice Address - Street 1:7 LEXINGTON AVE
Practice Address - Street 2:P2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5517
Practice Address - Country:US
Practice Address - Phone:212-996-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0522791103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NX7231Medicare ID - Type Unspecified