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General NPI Number Information
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NPI Number | 1174401103
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Entity Type | Individual
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Provider Name | JULIANNA SOPHIE KING OD
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1498 DEER PARK AVE
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City | NORTH BABYLON
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State | NY
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Zip | 11703-1208
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Country | US
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Telephone | 631-242-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 JONES AVE
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City | WANTAGH
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State | NY
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Zip | 11793-3818
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Country | US
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Telephone | 516-350-7060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 011299
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License Number State | NY
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