Provider Demographics
NPI:1164179115
Name:WILLIAMS, MAGALIS A
Entity Type:Individual
Prefix:
First Name:MAGALIS
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 LENOX AVE APT 13F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-4512
Mailing Address - Country:US
Mailing Address - Phone:929-270-8391
Mailing Address - Fax:
Practice Address - Street 1:111 N 3RD AVE APT 5T
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1377
Practice Address - Country:US
Practice Address - Phone:347-740-2640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent