Healthcare Provider Details

I. General information

NPI: 1942729181
Provider Name (Legal Business Name): JULIA NOUROK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 09/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 AMSTERDAM AVE
NEW YORK NY
10031-4611
US

IV. Provider business mailing address

1727 AMSTERDAM AVE
NEW YORK NY
10031-4611
US

V. Phone/Fax

Practice location:
  • Phone: 212-694-9200
  • Fax: 212-358-5608
Mailing address:
  • Phone: 212-694-9200
  • Fax: 212-368-5608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: