1568555357 NPI number — DR. JULIE S WHITNEY D.O.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568555357 NPI number — DR. JULIE S WHITNEY D.O.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

WHITNEY

Provider First Name:

JULIE

Provider Middle Name:

S

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

D.O.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1568555357

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/07/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

401 ROUTE 73 N STE 320

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MARLTON

Provider Business Mailing Address State Name:

NJ

Provider Business Mailing Address Postal Code:

08053-3426

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

535 S BLACK HORSE PIKE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

BLACKWOOD

Provider Business Practice Location Address State Name:

NJ

Provider Business Practice Location Address Postal Code:

08012-2807

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

856-228-1061

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

10/02/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207PE0004X , with the licence number:  25MB07610700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208000000X , with the licence number: 25MB07610700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 010006261 00 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 60005607 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: P3573479 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 0008516 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 1595780 . This is a "AMERIHEALTH PPO/PA BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 37696 . This is a "UNIVERSITY HEALTH PLAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 1097406 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 2273116000 . This is a "AMERIHEALTH/KEYSTONE/IBC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 3552240 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".