Provider Demographics
NPI:1194769984
Name:MCCALL-MBOYA, JULIA M (DPM)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:M
Last Name:MCCALL-MBOYA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:385 TREMONT AVE
Mailing Address - Street 2:112
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1023
Mailing Address - Country:US
Mailing Address - Phone:973-676-1000
Mailing Address - Fax:973-395-7154
Practice Address - Street 1:385 TREMONT AVE
Practice Address - Street 2:112
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1023
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:973-395-7154
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003636L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist