Provider Demographics
NPI:1609841089
Name:LEVINE, JULIE WILMOT (PHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:WILMOT
Last Name:LEVINE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 N TRIPHAMMER RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1576
Mailing Address - Country:US
Mailing Address - Phone:607-330-5692
Mailing Address - Fax:
Practice Address - Street 1:2255 N TRIPHAMMER RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1576
Practice Address - Country:US
Practice Address - Phone:607-844-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046069-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist