Provider Demographics
NPI:1760376701
Name:DUARDO, JULIA ROSE (ATC)
Entity type:Individual
Prefix:
First Name:JULIA ROSE
Middle Name:
Last Name:DUARDO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-1641
Mailing Address - Country:US
Mailing Address - Phone:201-306-2556
Mailing Address - Fax:
Practice Address - Street 1:120 VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2321
Practice Address - Country:US
Practice Address - Phone:201-490-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT003409002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer