Provider Demographics
NPI:1336658079
Name:CARR, JULIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 POINT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-1923
Mailing Address - Country:US
Mailing Address - Phone:518-727-0587
Mailing Address - Fax:
Practice Address - Street 1:132 W 96TH ST OFC 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6418
Practice Address - Country:US
Practice Address - Phone:212-249-2758
Practice Address - Fax:212-249-2506
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist