Healthcare Provider Details

I. General information

NPI: 1730874983
Provider Name (Legal Business Name): JULIA ROSE SLYER-FITCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA ROSE SLYER MD

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 EMPIRE STATE BLVD
CASTLETON NY
12033-9777
US

IV. Provider business mailing address

6 WELLNESS WAY STE 201
LATHAM NY
12110-2156
US

V. Phone/Fax

Practice location:
  • Phone: 518-477-2167
  • Fax: 518-477-5182
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number64832
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number343741
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: