Provider Demographics
NPI:1255530689
Name:ERCK, JULIA ANN
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:ERCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20554 SAINT LAWRENCE PARK RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA BAY
Mailing Address - State:NY
Mailing Address - Zip Code:13607-2116
Mailing Address - Country:US
Mailing Address - Phone:315-482-3591
Mailing Address - Fax:
Practice Address - Street 1:81 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA BAY
Practice Address - State:NY
Practice Address - Zip Code:13607-1815
Practice Address - Country:US
Practice Address - Phone:315-482-9719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282416-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse