Healthcare Provider Details

I. General information

NPI: 1639047418
Provider Name (Legal Business Name): JULIA VREESWYK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD STE 300
WEST CHESTER PA
19380-3431
US

IV. Provider business mailing address

214 DEBAPTISTE LN
WEST CHESTER PA
19382-2863
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-3122
  • Fax:
Mailing address:
  • Phone: 610-431-3122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA067296
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: