Provider Demographics
NPI:1356302186
Name:URENA, JULIO H (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:H
Last Name:URENA
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 1:40 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2219
Mailing Address - Country:US
Mailing Address - Phone:973-574-0010
Mailing Address - Fax:973-574-0031
Practice Address - Street 1:40 UNION AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2219
Practice Address - Country:US
Practice Address - Phone:973-574-0010
Practice Address - Fax:973-574-0031
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58979207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6048102Medicaid
NJF71364Medicare UPIN
NJ6048102Medicaid