Provider Demographics
NPI:1912044900
Name:MASTER, JULIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:MASTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6619
Mailing Address - Country:US
Mailing Address - Phone:732-263-5024
Mailing Address - Fax:
Practice Address - Street 1:166 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6619
Practice Address - Country:US
Practice Address - Phone:732-263-5024
Practice Address - Fax:732-263-5029
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08744700207RC0000X
NY241171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease