Provider Demographics
NPI:1366761868
Name:GARAY-DANIEL, JULIA MARIA (LPN)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:MARIA
Last Name:GARAY-DANIEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 PARK AVE
Mailing Address - Street 2:33 PARK AVE.
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-1842
Mailing Address - Country:US
Mailing Address - Phone:845-707-4074
Mailing Address - Fax:
Practice Address - Street 1:396 BROADWAY
Practice Address - Street 2:396 BROADWAY
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1157
Practice Address - Country:US
Practice Address - Phone:845-794-8080
Practice Address - Fax:845-794-8343
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY074238-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)