Healthcare Provider Details

I. General information

NPI: 1255545760
Provider Name (Legal Business Name): JULIE ERICA MARX M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW CHILDREN'S NATIONAL MEDICAL CENTER
WASHINGTON DC
20010-2978
US

IV. Provider business mailing address

19 DEER CHASE RD
MORRISTOWN NJ
07960-2802
US

V. Phone/Fax

Practice location:
  • Phone: 202-884-3730
  • Fax: 202-884-2399
Mailing address:
  • Phone: 646-263-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number242251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: