Provider Demographics
NPI:1801693981
Name:BOMBARA, JULIANE
Entity type:Individual
Prefix:
First Name:JULIANE
Middle Name:
Last Name:BOMBARA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4610
Mailing Address - Country:US
Mailing Address - Phone:516-974-1501
Mailing Address - Fax:
Practice Address - Street 1:2905 HARBOR RD
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4610
Practice Address - Country:US
Practice Address - Phone:516-974-1501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program