Provider Demographics
NPI:1215074810
Name:WILLIAMS, MELISSA YVETTE (CMA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:YVETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15A WATERVIEW COURT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:347-466-4135
Mailing Address - Fax:
Practice Address - Street 1:215 DRUM RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-5001
Practice Address - Country:US
Practice Address - Phone:718-354-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider