Provider Demographics
NPI:1407273394
Name:GERMINO, JULIE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:GERMINO
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 E 85TH ST APT 24A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2147
Mailing Address - Country:US
Mailing Address - Phone:631-805-3642
Mailing Address - Fax:
Practice Address - Street 1:185 E 85TH ST APT 24A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2147
Practice Address - Country:US
Practice Address - Phone:631-805-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY676724121174400000X
NY676571121174400000X
NY676570121174400000X
NY001865-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist