Provider Demographics
NPI:1568001972
Name:LOVE, WILLIAM B
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:B
Last Name:LOVE
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 1:2050 FREDERICK DOUGLAS BLVD #2-10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3236
Mailing Address - Country:US
Mailing Address - Phone:929-339-7129
Mailing Address - Fax:
Practice Address - Street 1:2050 FREDERICK DOUGLAS BLVD #2-10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-3236
Practice Address - Country:US
Practice Address - Phone:929-339-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider