Provider Demographics
NPI:1124591904
Name:MOCHULSKY, JULIA MUZZARELLI (PA)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:MUZZARELLI
Last Name:MOCHULSKY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:MUZZARELLI
Other - Last Name:STOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:112 W SPENCER AVE
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2545
Mailing Address - Country:US
Mailing Address - Phone:970-641-8899
Mailing Address - Fax:
Practice Address - Street 1:112 W SPENCER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230
Practice Address - Country:US
Practice Address - Phone:970-641-6788
Practice Address - Fax:970-641-0282
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006206363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical