Provider Demographics
NPI:1881791903
Name:DE JULIIS, AURORA (MD)
Entity type:Individual
Prefix:DR
First Name:AURORA
Middle Name:
Last Name:DE JULIIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MACOPIN AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2002
Mailing Address - Country:US
Mailing Address - Phone:973-338-6300
Mailing Address - Fax:973-338-5347
Practice Address - Street 1:1018 BROAD ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2884
Practice Address - Country:US
Practice Address - Phone:973-338-6300
Practice Address - Fax:973-338-5347
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04328500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC55443Medicare UPIN
NJDE453218Medicare ID - Type Unspecified