Provider Demographics
NPI:1366877185
Name:ALMEYDA, JULIO C (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:C
Last Name:ALMEYDA
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 JULIE LN
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1511
Mailing Address - Country:US
Mailing Address - Phone:516-318-9269
Mailing Address - Fax:
Practice Address - Street 1:2780 MIDDLE COUNTRY RD
Practice Address - Street 2:SUIT 140
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2124
Practice Address - Country:US
Practice Address - Phone:631-580-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014580363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant