Healthcare Provider Details

I. General information

NPI: 1720206287
Provider Name (Legal Business Name): JOHN S. JULIANO, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HATFIELD LN SUITE 107
GOSHEN NY
10924-6766
US

IV. Provider business mailing address

30 HATFIELD LN SUITE 107
GOSHEN NY
10924-6766
US

V. Phone/Fax

Practice location:
  • Phone: 845-294-7703
  • Fax: 845-294-7974
Mailing address:
  • Phone: 845-294-7703
  • Fax: 845-294-7974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number213968-1
License Number StateNY

VIII. Authorized Official

Name: DR. JOHN STEPHEN JULIANO
Title or Position: CEO
Credential: MD
Phone: 845-294-7703