Provider Demographics
NPI:1306178983
Name:WILLIAMS, BRYAN HUGH (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:HUGH
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 HEMPHILL PL
Mailing Address - Street 2:SUITE #116
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4419
Mailing Address - Country:US
Mailing Address - Phone:518-899-6063
Mailing Address - Fax:518-899-6064
Practice Address - Street 1:3 HEMPHILL PL
Practice Address - Street 2:SUITE #116
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-4419
Practice Address - Country:US
Practice Address - Phone:518-899-6063
Practice Address - Fax:518-899-6064
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist