Individual
JOSEPHINE DWINTARTI JULIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5116 74TH ST, ELMHURST, NY 11373-4107
(484) 684-7552
Mailing address
201 E 65TH ST, NEW YORK, NY 10065-6701
(212) 879-4700
(212) 249-7580
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT188462
PA
Other
Enumeration date
09/21/2007
Last updated
09/11/2024
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