Provider Demographics
NPI:1225042344
Name:ORMISTON, JULIE C (RPA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:ORMISTON
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3722
Mailing Address - Country:US
Mailing Address - Phone:845-561-1575
Mailing Address - Fax:845-561-1796
Practice Address - Street 1:308 FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3722
Practice Address - Country:US
Practice Address - Phone:845-561-1575
Practice Address - Fax:845-561-1796
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004579-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY986410OtherMVP
NYOF1272Medicare ID - Type Unspecified
NYOF1271Medicare ID - Type Unspecified