Provider Demographics
NPI:1568581874
Name:GOLD, JULIA LUISA (OTR)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:LUISA
Last Name:GOLD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:VASSALLUZZO
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:21 HARDSCRABBLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5907
Mailing Address - Country:US
Mailing Address - Phone:908-782-0721
Mailing Address - Fax:
Practice Address - Street 1:1660 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1202
Practice Address - Country:US
Practice Address - Phone:215-345-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001122L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist