Provider Demographics
NPI:1013153808
Name:DANIEL E WILLIAMS PHD PA
Entity type:Organization
Organization Name:DANIEL E WILLIAMS PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-675-9200
Mailing Address - Street 1:185 CENTRAL AVE STE 615
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3319
Mailing Address - Country:US
Mailing Address - Phone:973-675-9200
Mailing Address - Fax:973-678-8432
Practice Address - Street 1:185 CENTRAL AVE STE 615
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3319
Practice Address - Country:US
Practice Address - Phone:973-675-9200
Practice Address - Fax:973-678-8432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-28
Last Update Date:2008-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ897261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0492400Medicaid