Individual
JULIE MOON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 MARION RD, ARLINGTON, MA 02474
(516) 765-0233
Mailing address
15 MAIN ST STE 173, WATERTOWN, MA 02472-4403
(516) 765-0233
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1185112
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1185112
NCCPA
MA
Enumeration date
06/24/2021
Last updated
06/24/2021
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