Provider Demographics
NPI:1891029773
Name:RAASHAN C. WILLIAMS, MD, FACC, LLC
Entity Type:Organization
Organization Name:RAASHAN C. WILLIAMS, MD, FACC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:RAASHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-758-8000
Mailing Address - Street 1:3196 KENNEDY BLVD
Mailing Address - Street 2:2A
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-6439
Mailing Address - Country:US
Mailing Address - Phone:201-758-8000
Mailing Address - Fax:201-758-8003
Practice Address - Street 1:3196 KENNEDY BLVD THIRD FLOOR
Practice Address - Street 2:2A
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-6439
Practice Address - Country:US
Practice Address - Phone:201-758-8000
Practice Address - Fax:201-758-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08095300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0112429Medicaid