Provider Demographics
NPI:1447329305
Name:GIVEN, WILLIAM P (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:GIVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:P
Other - Last Name:GIVEN
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:287 NORTHERN BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4717
Mailing Address - Country:US
Mailing Address - Phone:516-487-0757
Mailing Address - Fax:516-487-5464
Practice Address - Street 1:1999 MARCUS AVE STE 306
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1028
Practice Address - Country:US
Practice Address - Phone:516-467-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139795207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C12343Medicare UPIN
NY92A581Medicare ID - Type Unspecified