Provider Demographics
NPI:1659666741
Name:WILLIAMS, AMUNDSON CLAUDIUS
Entity Type:Individual
Prefix:
First Name:AMUNDSON
Middle Name:CLAUDIUS
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 1:10 HAAG ST
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1113
Mailing Address - Country:US
Mailing Address - Phone:732-925-4898
Mailing Address - Fax:
Practice Address - Street 1:10 HAAG ST
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1113
Practice Address - Country:US
Practice Address - Phone:732-925-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305010164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse