Provider Demographics
NPI:1194748632
Name:KARDOS, JULIE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:KARDOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PHEASANT RUN
Mailing Address - Street 2:NEWTON PAVILLION, SUITE 105
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-968-6844
Mailing Address - Fax:215-968-4519
Practice Address - Street 1:104 PHEASANT RUN
Practice Address - Street 2:NEWTON PAVILLION, SUITE 105
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3439
Practice Address - Country:US
Practice Address - Phone:215-968-6844
Practice Address - Fax:215-968-4519
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-059788-L208000000X
NJ25-MA-06658300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016556050003Medicaid
KA96044Medicare ID - Type Unspecified
PA0016556050003Medicaid