Healthcare Provider Details

I. General information

NPI: 1215544176
Provider Name (Legal Business Name): JULI ANN PALATTY DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROSPECT AVE STE 615
HACKENSACK NJ
07601-1997
US

IV. Provider business mailing address

709 TULANE CT
TOWNSHIP OF WASHINGTON NJ
07676-4222
US

V. Phone/Fax

Practice location:
  • Phone: 973-919-2806
  • Fax:
Mailing address:
  • Phone: 845-323-1139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01058900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: