Provider Demographics
NPI:1982598389
Name:MUNOZ, JULIE RAFAELA
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:RAFAELA
Last Name:MUNOZ
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 1:603 N CAYUGA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3600
Mailing Address - Country:US
Mailing Address - Phone:707-671-6996
Mailing Address - Fax:
Practice Address - Street 1:215 E STATE ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5547
Practice Address - Country:US
Practice Address - Phone:707-671-6996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program