Provider Demographics
NPI:1407591639
Name:WILLIAMS, GLORY J
Entity Type:Individual
Prefix:
First Name:GLORY
Middle Name:J
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 1:337 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3703
Mailing Address - Country:US
Mailing Address - Phone:033-644-4152
Mailing Address - Fax:646-893-4424
Practice Address - Street 1:337 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3703
Practice Address - Country:US
Practice Address - Phone:203-364-4415
Practice Address - Fax:646-893-4424
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management