Provider Demographics
NPI:1346412087
Name:LEE, JULIA T
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:T
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MARIANNA
Other - Last Name:TOMPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:THREE BRIDGES
Mailing Address - State:NJ
Mailing Address - Zip Code:08887-0310
Mailing Address - Country:US
Mailing Address - Phone:908-806-2645
Mailing Address - Fax:908-806-5228
Practice Address - Street 1:562 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1900
Practice Address - Country:US
Practice Address - Phone:732-565-5455
Practice Address - Fax:732-565-5454
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01096700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist