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General NPI Number Information
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NPI Number | 1356835318
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Entity Type | Individual
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Provider Name | JULIANN AISHA BRODERICK ALLEN
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 10 HOSPITAL DR
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City | HOLYOKE
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State | MA
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Zip | 01040-6643
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Country | US
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Telephone | 413-534-2682
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Fax |
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Provider Business Mailing Address
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Address Line | 350 ENGLE ST
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-1898
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Country | US
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Telephone |
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 1018981
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License Number State | MA
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