Provider Demographics
NPI:1316201353
Name:TARTARO, JULIE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:TARTARO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:F
Other - Last Name:SALVATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:395 CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-1602
Mailing Address - Country:US
Mailing Address - Phone:516-804-8656
Mailing Address - Fax:
Practice Address - Street 1:47 HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4022
Practice Address - Country:US
Practice Address - Phone:516-921-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317659174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist