Provider Demographics
NPI:1043709330
Name:BELL, JULIANKA A (RD)
Entity Type:Individual
Prefix:
First Name:JULIANKA
Middle Name:A
Last Name:BELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MOTHER GASTON BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-2510
Mailing Address - Country:US
Mailing Address - Phone:240-462-6321
Mailing Address - Fax:
Practice Address - Street 1:12 MOTHER GASTON BLVD APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-2510
Practice Address - Country:US
Practice Address - Phone:240-462-6321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86052296133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered