Provider Demographics
NPI:1326074394
Name:OLIN, JULIA A (MS,PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:A
Last Name:OLIN
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:A
Other - Last Name:RONDELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3073
Mailing Address - Country:US
Mailing Address - Phone:585-227-2310
Mailing Address - Fax:
Practice Address - Street 1:515 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3073
Practice Address - Country:US
Practice Address - Phone:585-227-2310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0244991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB6729Medicare PIN