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Individual
MR. WILLIAM LARSEN
Active
Individual
MR. WILLIAM LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
339752
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04173960
—
NY
01
—
1088
TOTAL CARE GROUP
NY
01
—
2734852
MEDICAID GROUP
NY
Enumeration date
06/16/2015
Last updated
08/23/2022
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