Basic Information
Provider Information
NPI: 1558514968
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: JULIE
MiddleName: EILEEN
NamePrefix: MRS.
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 CARNEGIE PLZ
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080031000
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Practice Location
Address1: 7 CARNEGIE PLZ
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080031000
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Other Information
ProviderEnumerationDate: 10/29/2008
LastUpdateDate: 04/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOC002710LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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