Provider Demographics
NPI:1285648212
Name:MESSER, JULIO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:MESSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0301
Mailing Address - Country:US
Mailing Address - Phone:212-288-8787
Mailing Address - Fax:212-628-0194
Practice Address - Street 1:123 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0301
Practice Address - Country:US
Practice Address - Phone:212-288-8787
Practice Address - Fax:212-628-0194
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148783207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00722885Medicaid
NY72A801Medicare ID - Type Unspecified
NY00722885Medicaid