Provider Demographics
NPI:1225165723
Name:ORDONEZ, JULIA I (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:I
Last Name:ORDONEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK CHILDRENS SERVICES HSC
Mailing Address - Street 2:T-11, 020
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8111
Mailing Address - Country:US
Mailing Address - Phone:516-801-3771
Mailing Address - Fax:
Practice Address - Street 1:2701 SUNRISE HWY
Practice Address - Street 2:STONY BROOK CHILDREN'S SERVICES UFPC
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2642
Practice Address - Country:US
Practice Address - Phone:631-638-2375
Practice Address - Fax:631-581-9561
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225289208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02318909Medicaid
NY02318909Medicaid
NYH82068Medicare UPIN