Provider Demographics
NPI:1427367341
Name:BLACHEK, JULIE A (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BLACHEK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:TEED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:22 ST PAUL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-1033
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:717-263-2055
Practice Address - Street 1:830 5TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4224
Practice Address - Country:US
Practice Address - Phone:717-709-7950
Practice Address - Fax:717-263-8898
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical