Provider Demographics
NPI:1235391673
Name:SANICOLA-JOHNSON, JULIE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:SANICOLA-JOHNSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ANN ST
Mailing Address - Street 2:#N304
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2143
Mailing Address - Country:US
Mailing Address - Phone:240-217-2182
Mailing Address - Fax:
Practice Address - Street 1:2 ANN ST
Practice Address - Street 2:#N304
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2143
Practice Address - Country:US
Practice Address - Phone:240-217-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH78985207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine