Provider Demographics
NPI:1811213655
Name:AKKERMAN, JULIA (DPM)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:AKKERMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ALBANY ST
Mailing Address - Street 2:APT 5E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10280-1404
Mailing Address - Country:US
Mailing Address - Phone:201-893-3174
Mailing Address - Fax:
Practice Address - Street 1:1122 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2345
Practice Address - Country:US
Practice Address - Phone:718-434-2600
Practice Address - Fax:718-434-2601
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006535213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03824513Medicaid