Provider Demographics
NPI:1356921506
Name:BALAN, JULIA
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:BALAN
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 1:24 HUTTON AVE APT 17
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4831
Mailing Address - Country:US
Mailing Address - Phone:551-580-2451
Mailing Address - Fax:
Practice Address - Street 1:18-01 POLLITT DR STE 1A
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2815
Practice Address - Country:US
Practice Address - Phone:201-478-4200
Practice Address - Fax:201-478-4201
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09194800224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty