Healthcare Provider Details

I. General information

NPI: 1053670646
Provider Name (Legal Business Name): JULIE YIP D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 06/19/2025
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 WEST MAIN ST. UNIT 106
MILFORD CT
06460-2560
US

IV. Provider business mailing address

47 CLAPBOARD HILL RD STE 2
GUILFORD CT
06437-2282
US

V. Phone/Fax

Practice location:
  • Phone: 203-878-4312
  • Fax: 203-878-4151
Mailing address:
  • Phone: 203-789-2255
  • Fax: 203-495-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number61817
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: