Provider Demographics
NPI:1710144415
Name:SHIFREEN, JULIE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:SHIFREEN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2907
Mailing Address - Country:US
Mailing Address - Phone:860-570-3400
Mailing Address - Fax:860-570-0750
Practice Address - Street 1:645 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2907
Practice Address - Country:US
Practice Address - Phone:860-570-3400
Practice Address - Fax:860-570-0750
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist