Provider Demographics
NPI:1518187848
Name:DRAKE, JULIE (CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 91ST ST
Mailing Address - Street 2:APT. 97
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1321
Mailing Address - Country:US
Mailing Address - Phone:212-769-9698
Mailing Address - Fax:
Practice Address - Street 1:21 AUDUBON AVE.
Practice Address - Street 2:FAMILY PLANNING CLINIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-342-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000301367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife