Provider Demographics
NPI:1003808296
Name:GROVER, JULIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:GROVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HANDLEY ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:NY
Mailing Address - Zip Code:14530-1342
Mailing Address - Country:US
Mailing Address - Phone:585-237-3227
Mailing Address - Fax:585-237-6075
Practice Address - Street 1:3 HANDLEY ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:NY
Practice Address - Zip Code:14530-1342
Practice Address - Country:US
Practice Address - Phone:585-237-3227
Practice Address - Fax:585-237-6075
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332449363LF0000X
NYF332449363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01922930Medicaid
BB5705Medicare ID - Type Unspecified
S84860Medicare UPIN