Provider Demographics
NPI:1710019773
Name:WILLIAMS, DOLORES V (BSPT)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:V
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8527 ETON ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2406
Mailing Address - Country:US
Mailing Address - Phone:718-450-5414
Mailing Address - Fax:718-785-5715
Practice Address - Street 1:3247 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2015
Practice Address - Country:US
Practice Address - Phone:718-593-4157
Practice Address - Fax:718-785-5715
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy