Provider Demographics
NPI:1831312065
Name:WILLIAMS, PAMELA YVETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:YVETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5246
Mailing Address - Country:US
Mailing Address - Phone:973-471-8006
Mailing Address - Fax:973-471-1630
Practice Address - Street 1:111 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5246
Practice Address - Country:US
Practice Address - Phone:973-471-8006
Practice Address - Fax:973-471-1630
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0587722084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7006004Medicaid
NJ7006004Medicaid
NJG32417Medicare UPIN