Provider Demographics
NPI:1891160370
Name:SHALEK, JULIANA
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:SHALEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 88TH ST
Mailing Address - Street 2:APT 17D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4988
Mailing Address - Country:US
Mailing Address - Phone:924-498-0223
Mailing Address - Fax:
Practice Address - Street 1:19 W 44TH ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-5902
Practice Address - Country:US
Practice Address - Phone:914-498-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008498133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000695941Medicaid
NY331945Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY000695941Medicaid
NY331947Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification