Provider Demographics
NPI:1710310313
Name:BIZERRIL-WILLIAMS, JULIANA FONTENELE
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:FONTENELE
Last Name:BIZERRIL-WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:FONTENELE
Other - Last Name:BIZERRIL WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:267A W 231ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3903
Mailing Address - Country:US
Mailing Address - Phone:718-432-8282
Mailing Address - Fax:
Practice Address - Street 1:267A W 231ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3903
Practice Address - Country:US
Practice Address - Phone:718-432-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016809-1363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY016809-1OtherSTATE LICENSEE