Provider Demographics
NPI:1376968958
Name:BEAN, JULIA MARIE (PT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:BEAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 S BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1381
Mailing Address - Country:US
Mailing Address - Phone:908-783-4804
Mailing Address - Fax:
Practice Address - Street 1:65 S BEVERLY DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1381
Practice Address - Country:US
Practice Address - Phone:908-783-4804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist