Healthcare Provider Details

I. General information

NPI: 1427966100
Provider Name (Legal Business Name): JULIA ANN HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129A HILLSIDE AVE
WILLISTON PARK NY
11596-2305
US

IV. Provider business mailing address

210 PARK LN
MASSAPEQUA NY
11758-4311
US

V. Phone/Fax

Practice location:
  • Phone: 516-742-5243
  • Fax:
Mailing address:
  • Phone: 516-324-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: