Individual
JULIE S. CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1347
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8051
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15884
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026868
NEIGHBORHOOD HEALTH PLAN
MA
05
—
0396966
—
MA
01
—
908025
TUFTS HEALTH PLAN
MA
01
—
B501027
CIGNA
MA
01
—
HV0001
HARVARD PILGRIM
MA
01
—
UX8596
MEDICARE PTAN
MA
01
—
Y68073
BLUE CROSS
MA
Enumeration date
04/10/2006
Last updated
05/01/2008
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