Provider Demographics
NPI:1629656426
Name:WILLIAMS, SCHENELL TANIEL
Entity Type:Individual
Prefix:
First Name:SCHENELL
Middle Name:TANIEL
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 1:4 RESEARCH DR STE 402
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6242
Mailing Address - Country:US
Mailing Address - Phone:203-293-9300
Mailing Address - Fax:
Practice Address - Street 1:4 RESEARCH DR STE 402
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6242
Practice Address - Country:US
Practice Address - Phone:203-293-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies