Individual
JULIE C ORMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA
Contact information
Practice address
308 FULLERTON AVE, NEWBURGH, NY 12550-3722
(845) 561-1575
(845) 561-1796
Mailing address
308 FULLERTON AVE, NEWBURGH, NY 12550-3722
(845) 561-1575
(845) 561-1796
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004579-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
986410
MVP
NY
Enumeration date
07/27/2006
Last updated
07/08/2007
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