Provider Demographics
NPI:1427658533
Name:GUTMAN, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GUTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CINNABAR LN
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5728
Mailing Address - Country:US
Mailing Address - Phone:267-307-3781
Mailing Address - Fax:
Practice Address - Street 1:180 LEVITTOWN PKWY
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2456
Practice Address - Country:US
Practice Address - Phone:215-949-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042676R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist