Provider Demographics
NPI:1508501115
Name:WILLIAMS, MALIK JAMAL
Entity Type:Individual
Prefix:
First Name:MALIK
Middle Name:JAMAL
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 1:220-04 LINDEN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-6261
Mailing Address - Country:US
Mailing Address - Phone:718-712-3358
Mailing Address - Fax:
Practice Address - Street 1:220-04 LINDEN BOULEVARD
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1141
Practice Address - Country:US
Practice Address - Phone:347-201-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management