Healthcare Provider Details

I. General information

NPI: 1932651338
Provider Name (Legal Business Name): JULIE PLICHOTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24715 LITTLE MACK AVE STE 100
SAINT CLAIR SHORES MI
48080-3207
US

IV. Provider business mailing address

169 MADISON AVE STE 15501
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 586-204-8160
  • Fax:
Mailing address:
  • Phone: 385-308-8034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2025-0124
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT033243
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number054152-01
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501017229
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT021644
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: