Provider Demographics
NPI:1205060357
Name:MARTIN, JULIE ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 COUVERS CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16340-6637
Mailing Address - Country:US
Mailing Address - Phone:814-563-6354
Mailing Address - Fax:
Practice Address - Street 1:1079 MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-1269
Practice Address - Country:US
Practice Address - Phone:814-723-3248
Practice Address - Fax:814-726-9613
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP412578L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist