Provider Demographics
NPI:1235284183
Name:MAYKISH, JULIE (REGISTERED OCCUPATIO)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:MAYKISH
Suffix:
Gender:F
Credentials:REGISTERED OCCUPATIO
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PIEROTTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:556 EAGEL ROCK AVENUE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1503
Mailing Address - Country:US
Mailing Address - Phone:973-226-1655
Mailing Address - Fax:973-226-4502
Practice Address - Street 1:556 EAGLE ROCK AVENUE
Practice Address - Street 2:SUITE 208
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1503
Practice Address - Country:US
Practice Address - Phone:973-226-1655
Practice Address - Fax:973-226-4502
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00051200AA439463225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P37634Medicare UPIN
050103P25Medicare ID - Type Unspecified