Provider Demographics
NPI:1992839070
Name:NIEDWICK, JULIE MADEIRA (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MADEIRA
Last Name:NIEDWICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5507
Mailing Address - Country:US
Mailing Address - Phone:717-766-9700
Mailing Address - Fax:717-909-6870
Practice Address - Street 1:2106 ASPEN DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5507
Practice Address - Country:US
Practice Address - Phone:717-766-9700
Practice Address - Fax:717-909-6870
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006410L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA844792Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER