Provider Demographics
NPI:1497748834
Name:HERTKO-ADAMS, JULIANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:M
Last Name:HERTKO-ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:191 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7751
Mailing Address - Country:US
Mailing Address - Phone:617-773-5070
Mailing Address - Fax:617-472-2380
Practice Address - Street 1:191 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7751
Practice Address - Country:US
Practice Address - Phone:617-773-5070
Practice Address - Fax:617-472-2380
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA223876208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1497748834OtherTUFTS
MA9700919Medicaid
MA1497748834OtherBCBS
MA1497748834OtherUNITED HEALTHCARE
MA1497748834OtherHPHC