Provider Demographics
NPI:1578550430
Name:BRUCE, JULIA J (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:J
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3226
Mailing Address - Country:US
Mailing Address - Phone:603-335-8195
Mailing Address - Fax:603-330-0098
Practice Address - Street 1:15 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3226
Practice Address - Country:US
Practice Address - Phone:603-335-8195
Practice Address - Fax:603-330-0098
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9077207ZP0102X
ME014091207ZP0102X
MA212696207ZP0102X
VT0420008160207ZP0102X
IDM5487207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30006326Medicaid
NHE70366Medicare UPIN
NHBRRE3096Medicare ID - Type Unspecified