Provider Demographics
NPI:1093016982
Name:WILLIAMS, STEVEN HAMUEL JR (LPN)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HAMUEL
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 PARKDALE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3308
Mailing Address - Country:US
Mailing Address - Phone:631-667-1498
Mailing Address - Fax:
Practice Address - Street 1:76 PARKDALE DR
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3308
Practice Address - Country:US
Practice Address - Phone:631-667-1498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292723164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse