Provider Demographics
NPI:1821151994
Name:PAGE, JULIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTRAL AVE
Mailing Address - Street 2:UNIT 15
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1402
Mailing Address - Country:US
Mailing Address - Phone:732-291-5575
Mailing Address - Fax:
Practice Address - Street 1:68 1ST AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1286
Practice Address - Country:US
Practice Address - Phone:732-291-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC5907111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0554490Medicare ID - Type Unspecified