Provider Demographics
NPI:1316271851
Name:WAHNISH, JULIE ANN FERNAN
Entity type:Individual
Prefix:MRS
First Name:JULIE ANN
Middle Name:FERNAN
Last Name:WAHNISH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JULIE ANN
Other - Middle Name:FERNAN
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVENUE, SUITE 500S
Mailing Address - Street 2:UNIVERSITY ORTHOPAEDICS, PC
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-345-0825
Mailing Address - Fax:914-592-1809
Practice Address - Street 1:19 BRADHURST AVENUE, SUITE 500S
Practice Address - Street 2:UNIVERSITY ORTHOPAEDICS, PC
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-345-0825
Practice Address - Fax:914-592-1809
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026055-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist