Provider Demographics
NPI:1245423037
Name:ROSS, JULIE BREGMAN (MS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BREGMAN
Last Name:ROSS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8517 218TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1434
Mailing Address - Country:US
Mailing Address - Phone:646-752-7006
Mailing Address - Fax:718-892-6469
Practice Address - Street 1:1500 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1100
Practice Address - Country:US
Practice Address - Phone:718-730-1004
Practice Address - Fax:718-892-6469
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007938-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist