1558493205 NPI number — MS. JULIE CHOE CASADAY CNS

Table of content: MS. JULIE CHOE CASADAY CNS (NPI 1558493205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558493205 NPI number — MS. JULIE CHOE CASADAY CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASADAY
Provider First Name:
JULIE
Provider Middle Name:
CHOE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANTIN
Provider Other First Name:
JULIE
Provider Other Middle Name:
CHOE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558493205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
445 WINN WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DECATUR
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30030-1707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-508-7796
Provider Business Mailing Address Fax Number:
404-294-3710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3110 CLIFTON SPRINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30034-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-243-9500
Provider Business Practice Location Address Fax Number:
404-244-2224
Provider Enumeration Date:
03/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SP0809X , with the licence number:  RN114781 CNS-PMH , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)