Frederick Willis

Peer Specialist · Bronx, NY

Individual Active NPI

NPI number 1669194346

Practice location

3584 Jerome Ave
Bronx, NY 10467-1006
Phone
(718) 653-1537

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NPI record

NPI
1669194346
Entity type
Individual (Type 1)
Enumeration date
September 19, 2022
Last updated
September 19, 2022
Certified
September 19, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Peer Specialist Primary 175T00000X 4259 NY

Mailing address

79 Glenridge Rd
Glenville, NY 12302-4523

About Frederick Willis

Frederick Willis is a healthcare provider registered in the NPI registry with the primary taxonomy Peer Specialist (code 175T00000X). The practice location is 3584 Jerome Ave, Bronx, NY 10467-1006. The NPI number 1669194346 was assigned on September 19, 2022 and the record was last updated on September 19, 2022.

Frederick Willis lists a license in the registry: #4259 (NY) for Peer Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Frederick Willis?

The NPI number is 1669194346.

What is the phone number of Frederick Willis?

The phone number listed for the practice location is (718) 653-1537.

Where is Frederick Willis located?

3584 Jerome Ave, Bronx, NY 10467-1006.

What is the taxonomy code for Frederick Willis?

The primary taxonomy code is 175T00000X – Peer Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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