Provider Demographics
NPI:1407027600
Name:WILLIAMS, TERRENCE ALLEN
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:ALLEN
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 1:50 BROADWAY FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-3810
Mailing Address - Country:US
Mailing Address - Phone:917-305-7922
Mailing Address - Fax:917-305-7932
Practice Address - Street 1:50 BROADWAY FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-3810
Practice Address - Country:US
Practice Address - Phone:917-305-7922
Practice Address - Fax:917-305-7932
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000002846237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist