Provider Demographics
NPI:1376983809
Name:SHEVCHENKO, JULIA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:SHEVCHENKO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 PASSAIC ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-1355
Mailing Address - Country:US
Mailing Address - Phone:973-773-3800
Mailing Address - Fax:
Practice Address - Street 1:210 PASSAIC ST
Practice Address - Street 2:GARFIELD URGENT CARE CENTER
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1355
Practice Address - Country:US
Practice Address - Phone:973-773-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00448700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily