Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Frederick Willis

Individual provider Peer Specialist · NPI 1669194346

Frederick Willis is a Peer Specialist in Bronx, New York. Licensed in New York. Registered with an NPI since 2022.

Licensed in
NY
In the registry since
2022

Practice location Address checks out

3584 Jerome Ave
Bronx, NY 10467-1006
Phone: (718) 653-1537
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 4259 (NY)

Record details

NPI number1669194346
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 19, 2022
Last updated in NPPESSeptember 19, 2022
Certification dateSeptember 19, 2022
Mailing address79 Glenridge Rd, Glenville, NY 12302-4523

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