Provider Demographics
NPI:1073918819
Name:WILLIAMS, ALEJANDRO
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 E 34TH ST
Mailing Address - Street 2:1G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6160
Mailing Address - Country:US
Mailing Address - Phone:917-412-4103
Mailing Address - Fax:
Practice Address - Street 1:667 E 34TH ST
Practice Address - Street 2:1G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6160
Practice Address - Country:US
Practice Address - Phone:917-412-4103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268596164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse