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NPI Code Detail

MEDICARE: MS. JULIA RETTIG

MEDICARE: MS. JULIA RETTIG
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1154721280
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIA RETTIG
Provider Business Mailing Address
First Line : 14040 SANFORD AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2556
Country : US
Telephone Number : 718-553-1100
Fax Number :
Provider Business Practice Location Address
First Line : 14040 SANFORD AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2556
Country : US
Telephone Number : 718-553-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2014
Last Update Date : 03/17/2018

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