MEDICARE: MR. MICHAEL JULI LCSW

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	1041C0700X	Clinical Social Worker	083277	NY
2	104100000X	Social Worker	077525	NY

General Provider Information

NPI Number	:	1366688228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL JULI LCSW

Provider Business Mailing Address
First Line	:	8302 CORNISH AVE APT 4E
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-3710
Country	:	US
Telephone Number	:	917-371-8291
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 47TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3433
Country	:	US
Telephone Number	:	917-371-8291
Fax Number	:

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

Provider Enumeration Date	:	12/24/2008
Last Update Date	:	08/21/2020

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