Provider Demographics
NPI:1972978690
Name:LAROCCA, JULIA (NP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LAROCCA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:284 OWOSSO AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:5TH FLOOR, ACC
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:330-344-6015
Practice Address - Fax:330-344-6820
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18384-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0454744OtherAKRON GENERAL MEDICAL CENTER MEDICAID GROUP # (IMCA)
OH0152618Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH3600271OtherAKRON GENERAL MEDICAL CENTER MEDICARE GROUP # (IMCA)
OH0152618Medicaid
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #