Provider Demographics
NPI:1528202587
Name:IONESCU, JULIANA (PT)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:IONESCU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 7TH AVE W
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2333
Mailing Address - Country:US
Mailing Address - Phone:631-754-8530
Mailing Address - Fax:
Practice Address - Street 1:4 7TH AVE W
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-2333
Practice Address - Country:US
Practice Address - Phone:631-754-8530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014222-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist