Provider Demographics
NPI:1982018081
Name:JAMES, WILLIAM (ASSOCIATES / BM)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:ASSOCIATES / BM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 PARK HILL AVE
Mailing Address - Street 2:APT 1D
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4765
Mailing Address - Country:US
Mailing Address - Phone:917-561-2189
Mailing Address - Fax:206-339-2565
Practice Address - Street 1:225 PARK HILL AVE
Practice Address - Street 2:APT 1D
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4765
Practice Address - Country:US
Practice Address - Phone:864-494-2877
Practice Address - Fax:206-202-3912
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206339390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program