Individual
MR. WILLIE EDWARD NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRPA
Contact information
Practice address
2976 NORTHERN BLVD FL 2, LONG ISLAND CITY, NY 11101-2829
(212) 691-7554
Mailing address
2976 NORTHERN BLVD FL 2, LONG ISLAND CITY, NY 11101-2829
(212) 691-7554
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
P4766
NY
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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