Provider Demographics
NPI:1568555357
Name:WHITNEY, JULIE S (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:S
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:535 S BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2807
Practice Address - Country:US
Practice Address - Phone:856-228-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07610700207PE0004X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ010006261 00OtherAMERICHOICE
NJ60005607OtherHORIZON NJ HEALTH
NJP3573479OtherOXFORD
NJ0008516Medicaid
NJ1595780OtherAMERIHEALTH PPO/PA BS
NH37696OtherUNIVERSITY HEALTH PLAN
NJ1097406OtherCIGNA
NJ2273116000OtherAMERIHEALTH/KEYSTONE/IBC
NJ3552240OtherAETNA
NJ1595780OtherAMERIHEALTH PPO/PA BS
NJ2273116000OtherAMERIHEALTH/KEYSTONE/IBC