Provider Demographics
NPI:1013306786
Name:ZAVADENKO APN LLC, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ZAVADENKO APN LLC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:ZAVADENCO APN LLC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:678 ALEXANDER CT
Mailing Address - Street 2:
Mailing Address - City:RIVER VALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6403
Mailing Address - Country:US
Mailing Address - Phone:201-290-7957
Mailing Address - Fax:
Practice Address - Street 1:678 ALEXANDER CT
Practice Address - Street 2:
Practice Address - City:RIVER VALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-6403
Practice Address - Country:US
Practice Address - Phone:201-290-7957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00534000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health