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Individual

MS. JULIA M DIDDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPO, BOCO, BOCP

Contact information

Practice address
10 PROSPECT ST, C/O ORTHO CARE, INC, WESTFIELD, NJ 07090-2114
(908) 232-9910
(908) 232-9915
Mailing address
10 PROSPECT ST, C/O ORTHO CARE, INC, WESTFIELD, NJ 07090-2114
(908) 232-9910
(908) 232-9915

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
45PO00014100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0244376
NJ
01
223445698
HORIZON
NJ
Enumeration date
12/09/2012
Last updated
12/09/2012
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