Provider Demographics
NPI:1194311530
Name:COLLURA, JULIA (RN, BSN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:COLLURA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 S NAURAUSHAUN RD
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2919
Mailing Address - Country:US
Mailing Address - Phone:845-558-2767
Mailing Address - Fax:
Practice Address - Street 1:41 S NAURAUSHAUN RD
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2919
Practice Address - Country:US
Practice Address - Phone:845-558-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY774697163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical