MEDICARE: JULIANA M DEBITETTO RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	125.087353	IL

General Provider Information

NPI Number	:	1053119313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA M DEBITETTO RN

Provider Business Mailing Address
First Line	:	726 15TH ST S APT A
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-5577
Country	:	US
Telephone Number	:	973-713-8243
Fax Number	:

Provider Business Practice Location Address
First Line	:	726 15TH ST S APT A
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-5577
Country	:	US
Telephone Number	:	973-713-8243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	06/23/2026

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