Provider Demographics
NPI:1629333075
Name:BOWEN, JULIETTE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:JULIETTE
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MRS
Other - First Name:JULIETTE
Other - Middle Name:
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M/SED
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-0827
Mailing Address - Country:US
Mailing Address - Phone:914-310-4719
Mailing Address - Fax:
Practice Address - Street 1:360 MARKET STREET
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-0827
Practice Address - Country:US
Practice Address - Phone:914-310-4719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1199275174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist