Healthcare Provider Details

I. General information

NPI: 1255241535
Provider Name (Legal Business Name): JULIA TERRY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 E JIMMIE LEEDS RD
GALLOWAY NJ
08205-9705
US

IV. Provider business mailing address

836 CHESTNUT NECK RD
PORT REPUBLIC NJ
08241-9806
US

V. Phone/Fax

Practice location:
  • Phone: 640-210-3549
  • Fax:
Mailing address:
  • Phone: 609-668-8519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: