Provider Demographics
NPI:1851172480
Name:AHN, JULIE C (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:AHN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 NORTHERN BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3013
Mailing Address - Country:US
Mailing Address - Phone:516-365-5357
Mailing Address - Fax:
Practice Address - Street 1:1350 NORTHERN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3013
Practice Address - Country:US
Practice Address - Phone:516-365-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF352162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily