Provider Demographics
NPI:1982450250
Name:BENDITA, JULIANNE MAGDALENE (DPT)
Entity Type:Individual
Prefix:
First Name:JULIANNE MAGDALENE
Middle Name:
Last Name:BENDITA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 65TH RD APT 21B
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3242
Mailing Address - Country:US
Mailing Address - Phone:917-584-7361
Mailing Address - Fax:
Practice Address - Street 1:9712 65TH RD APT 21B
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3242
Practice Address - Country:US
Practice Address - Phone:917-584-7361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043384-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist