Provider Demographics
NPI:1700237773
Name:NEYEN, JULIA (PHD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:NEYEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 34TH ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-5144
Mailing Address - Country:US
Mailing Address - Phone:845-596-6917
Mailing Address - Fax:
Practice Address - Street 1:3017 34TH ST
Practice Address - Street 2:APT 1C
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-5144
Practice Address - Country:US
Practice Address - Phone:845-596-6917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool