Provider Demographics
NPI:1588972251
Name:BAILLIE, JULIEANNE P (RPH)
Entity type:Individual
Prefix:MRS
First Name:JULIEANNE
Middle Name:P
Last Name:BAILLIE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2723
Mailing Address - Country:US
Mailing Address - Phone:732-280-1600
Mailing Address - Fax:732-280-1666
Practice Address - Street 1:911 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2723
Practice Address - Country:US
Practice Address - Phone:732-280-1600
Practice Address - Fax:732-280-1666
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01864100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist