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General NPI Number Information
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NPI Number | 1801927199
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Entity Type | Individual
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Provider Name | JULIE W MCCONNELL MD
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 466 OLD HOOK ROAD SUITE 1
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City | EMERSON
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State | NJ
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Zip | 07630
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Country | US
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Telephone | 201-967-8221
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Fax | 201-634-9647
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Provider Business Mailing Address
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Address Line | 185 ROUTE 36 STE 130
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1339
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Country | US
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Telephone | 201-967-8221
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Fax | 201-634-9647
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 57316
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME87478
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA08278700
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License Number State | NJ
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