Provider Demographics
NPI:1184753493
Name:HERSKOWITZ, JULIA (LICAC)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:HERSKOWITZ
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BRADFORD TER
Mailing Address - Street 2:UNIT 2
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6000
Mailing Address - Country:US
Mailing Address - Phone:617-566-2383
Mailing Address - Fax:617-383-5787
Practice Address - Street 1:1601 WASHINGTON ST
Practice Address - Street 2:PATHWAYS TO WELLNESS - 3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-1951
Practice Address - Country:US
Practice Address - Phone:617-859-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA497171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist