Healthcare Provider Details

I. General information

NPI: 1053119313
Provider Name (Legal Business Name): JULIANA M DEBITETTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 15TH ST S APT A
ARLINGTON VA
22202-5577
US

IV. Provider business mailing address

726 15TH ST S APT A
ARLINGTON VA
22202-5577
US

V. Phone/Fax

Practice location:
  • Phone: 973-713-8243
  • Fax:
Mailing address:
  • Phone: 973-713-8243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125.087353
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: