Provider Demographics
NPI:1528154788
Name:ASUZU, JULIET JANE (MD,)
Entity type:Individual
Prefix:DR
First Name:JULIET
Middle Name:JANE
Last Name:ASUZU
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3631
Mailing Address - Street 2:BELLVIEW MEDICAL CLINIC
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17105-3631
Mailing Address - Country:US
Mailing Address - Phone:717-232-9555
Mailing Address - Fax:717-232-9550
Practice Address - Street 1:1118 N 3RD ST STE 100
Practice Address - Street 2:BELLVIEW MEDICAL CLINIC
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-2008
Practice Address - Country:US
Practice Address - Phone:717-232-9555
Practice Address - Fax:717-232-9550
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA066835-L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01937022Medicaid
PA01937022Medicaid
PAHO8924Medicare UPIN