Provider Demographics
NPI:1518987338
Name:TAW, JULIE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:TAW
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 5TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5631
Mailing Address - Country:US
Mailing Address - Phone:646-880-4465
Mailing Address - Fax:
Practice Address - Street 1:126 5TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5631
Practice Address - Country:US
Practice Address - Phone:646-880-4465
Practice Address - Fax:212-596-7138
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07464600207R00000X
NY220648207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0010219Medicaid
NJH41906Medicare UPIN
NJ0010219Medicaid