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1669194346
FREDERICK WILLIS
BRONX, NY
NPI
1669194346
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: NY 4259)
Enumeration Date
2022-09-19
Last Update Date
2022-09-19
Business Address
FREDERICK WILLIS
3584 JEROME AVE
BRONX, NY 10467-1006
Phone number: 718-653-1537
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Mailing Address
FREDERICK WILLIS
79 GLENRIDGE RD
GLENVILLE, NY 12302-4523
Phone number:
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