Provider Demographics
NPI:1396619060
Name:WILLIAMS, DESIREE G
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1126
Mailing Address - Country:US
Mailing Address - Phone:646-316-8096
Mailing Address - Fax:
Practice Address - Street 1:156 W 56TH ST STE 1804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3878
Practice Address - Country:US
Practice Address - Phone:212-662-9200
Practice Address - Fax:212-662-9222
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator