Healthcare Provider Details

I. General information

NPI: 1922036011
Provider Name (Legal Business Name): JULIA A BIRNBAUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRUCE STREET
PHILADELPHIA PA
19107-6130
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD GROUND FLOOR
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-3201
  • Fax: 215-829-5697
Mailing address:
  • Phone: 215-829-3201
  • Fax: 215-829-5697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD065540L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD065540L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: