=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255545760
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE ERICA MARX M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 MICHIGAN AVE NW CHILDREN'S NATIONAL MEDICAL CENTER
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20010-2978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-884-3730
-----------------------------------------------------
Fax | 202-884-2399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19 DEER CHASE RD
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07960-2802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-263-6789
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 242251
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------