Provider Demographics
NPI:1154682060
Name:FROUMKIN, JULIA (MS ED)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:FROUMKIN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1527
Mailing Address - Country:US
Mailing Address - Phone:516-417-4838
Mailing Address - Fax:
Practice Address - Street 1:217 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1527
Practice Address - Country:US
Practice Address - Phone:516-417-4838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1213647174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1213647Medicare UPIN