Provider Demographics
NPI:1629169677
Name:WILLIAMS, HOWARD C (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-0145
Mailing Address - Country:US
Mailing Address - Phone:516-443-3554
Mailing Address - Fax:631-224-4766
Practice Address - Street 1:111 BAYVIEW AVE
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-3122
Practice Address - Country:US
Practice Address - Phone:516-443-3554
Practice Address - Fax:631-224-4766
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161748-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60668Medicare UPIN
NY13E603Medicare ID - Type Unspecified