Provider Demographics
NPI:1518673953
Name:WILLIAMS, ROTIMI MAFOLASERE
Entity type:Individual
Prefix:DR
First Name:ROTIMI
Middle Name:MAFOLASERE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 LADDERBACK LN
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-5100
Mailing Address - Country:US
Mailing Address - Phone:148-317-2028
Mailing Address - Fax:
Practice Address - Street 1:65 LADDERBACK LN
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-5100
Practice Address - Country:US
Practice Address - Phone:148-317-2028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026893363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty