Willis, Frederick
Willis, Frederick is an individual health care provider with primary practice located at 3584 Jerome Ave , Bronx NY 10467-1006. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Willis, Frederick can be contacted via phone (718) 653-1537.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | 4259 | New York |
Profile Details
| NPI number | 1669194346 |
|---|---|
| LBN Legal business name | Willis, Frederick |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2022 |
| Last updated | Sep 19th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669194346 | NPPES |
| New York | MEDICAID | 01420795 |
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