Provider Demographics
NPI:1083094775
Name:PIECHAN, JULIE (MS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PIECHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:HICKERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CGC
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-0453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 PERRY PKWY
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2142
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99067494A170300000X
IN170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS