Provider Demographics
NPI:1124524772
Name:MICHALOWSKA, JULITA
Entity type:Individual
Prefix:
First Name:JULITA
Middle Name:
Last Name:MICHALOWSKA
Suffix:
Gender:F
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 BOWFELL CT
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2145
Mailing Address - Country:US
Mailing Address - Phone:201-410-9559
Mailing Address - Fax:
Practice Address - Street 1:245 ENGLE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2465
Practice Address - Country:US
Practice Address - Phone:201-569-5330
Practice Address - Fax:201-871-9722
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00789900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health