Provider Demographics
NPI:1477807824
Name:RAND, JULIE ROBIN
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ROBIN
Last Name:RAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E 64TH ST
Mailing Address - Street 2:APT. E8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7853
Mailing Address - Country:US
Mailing Address - Phone:516-633-2748
Mailing Address - Fax:
Practice Address - Street 1:420 E 64TH ST
Practice Address - Street 2:APT. E8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7853
Practice Address - Country:US
Practice Address - Phone:516-633-2748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY627 164 927174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist