Provider Demographics
NPI:1740237544
Name:FURLONG-JULIA, ELLEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:M
Last Name:FURLONG-JULIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:M
Other - Last Name:FURLONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:3201 HIGHFIELD DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1113
Practice Address - Country:US
Practice Address - Phone:610-868-0775
Practice Address - Fax:610-954-5538
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039239L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01056803OtherCAPITAL BLUE CROSS
PA370006547OtherPALMETTO RR
PA101785OtherHIGHMARK PA BLUE SHIELD
PAG22167Medicare UPIN
PA370006547OtherPALMETTO RR