Healthcare Provider Details

I. General information

NPI: 1730093709
Provider Name (Legal Business Name): MR. KEVIN JULIANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 COLVIN BLVD
TONAWANDA NY
14150-6973
US

IV. Provider business mailing address

1914 COLVIN BLVD
TONAWANDA NY
14150-6973
US

V. Phone/Fax

Practice location:
  • Phone: 716-525-8761
  • Fax:
Mailing address:
  • Phone: 716-525-8761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004980-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: