MEDICARE: JULIE ROSE SIGUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	043998	NY

General Provider Information

NPI Number	:	1306364138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ROSE SIGUE

Provider Business Mailing Address
First Line	:	5141 SIMONSON ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4252
Country	:	US
Telephone Number	:	929-253-5281
Fax Number	:

Provider Business Practice Location Address
First Line	:	5141 SIMONSON ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4252
Country	:	US
Telephone Number	:	929-253-5281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	07/18/2019

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Directions to “ JULIE ROSE SIGUE ” Practice Location

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