Provider Demographics
NPI:1982671442
Name:MCNAIRN, JULIE DK (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:DK
Last Name:MCNAIRN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 HANSHAW RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1589
Mailing Address - Country:US
Mailing Address - Phone:607-257-6563
Mailing Address - Fax:607-257-1420
Practice Address - Street 1:840 HANSHAW RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1589
Practice Address - Country:US
Practice Address - Phone:607-257-6563
Practice Address - Fax:607-257-1420
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235631207KA0200X, 207R00000X, 208M00000X
OH35.091987207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02674239Medicaid
NYJ400043172Medicare PIN
NY02674239Medicaid