Individual
JULIA ROSE KOEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(516) 592-9017
Mailing address
67 MELROSE AVE, LYNBROOK, NY 11563-3717
(516) 592-9017
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0000000000
NY
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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