Provider Demographics
NPI:1790546331
Name:TRESCO, JULIE M (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:TRESCO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 VANDERWATER RD # 96
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12493-7014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 VANDERWATER RD # 96
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:NY
Practice Address - Zip Code:12493-7014
Practice Address - Country:US
Practice Address - Phone:845-270-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY686413-01163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy