Provider Demographics
NPI:1821586181
Name:WILLIAMS, CRAIG STEVEN JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:STEVEN
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DE KRUIF PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-2201
Mailing Address - Country:US
Mailing Address - Phone:646-577-8077
Mailing Address - Fax:
Practice Address - Street 1:140 DE KRUIF PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-2201
Practice Address - Country:US
Practice Address - Phone:646-577-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003417-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer