Provider Demographics
NPI:1023641248
Name:CLAYTON, JULIA NICOLE (PT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:NICOLE
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COUNTRY SIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-4313
Mailing Address - Country:US
Mailing Address - Phone:973-867-8556
Mailing Address - Fax:
Practice Address - Street 1:60 MORRIS TPKE STE 2W
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-5007
Practice Address - Country:US
Practice Address - Phone:908-598-9009
Practice Address - Fax:973-218-9717
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT002989002255A2300X
NJ40QA021973002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer