Provider Demographics
NPI:1457795064
Name:RAYMOND, JULIAN THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:THOMAS
Last Name:RAYMOND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E 70TH ST APT GF
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5425
Mailing Address - Country:US
Mailing Address - Phone:212-804-8559
Mailing Address - Fax:917-410-7504
Practice Address - Street 1:214 E 70TH ST APT GF
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5425
Practice Address - Country:US
Practice Address - Phone:212-804-8559
Practice Address - Fax:917-410-7504
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor