Provider Demographics
NPI:1861685216
Name:RIFTINE, JULIA (MD, FCOG)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:RIFTINE
Suffix:
Gender:F
Credentials:MD, FCOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 RIVER ROAD
Mailing Address - Street 2:APT 4D
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1460
Mailing Address - Country:US
Mailing Address - Phone:201-392-3063
Mailing Address - Fax:201-392-3069
Practice Address - Street 1:55 MEADOWLANDS PKWY
Practice Address - Street 2:SUITE 436
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2977
Practice Address - Country:US
Practice Address - Phone:201-392-3063
Practice Address - Fax:201-392-3069
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08303000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0324680Medicaid
NJ354359Medicare PIN