Individual
ISRAEL WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453
(718) 299-7295
Mailing address
3198 GRAND CONCOURSE, BRONX, NY 10458-1000
(718) 618-0401
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
268360-1
NY
Other
Enumeration date
02/13/2013
Last updated
11/20/2018
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