Provider Demographics
NPI:1407308547
Name:JULIANO, CODY JANE (MED)
Entity Type:Individual
Prefix:MS
First Name:CODY
Middle Name:JANE
Last Name:JULIANO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:CODY
Other - Middle Name:JANE
Other - Last Name:POTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 SYLVAN WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-4474
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:889 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-3067
Practice Address - Country:US
Practice Address - Phone:508-771-2402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst