1508169582 NPI number — DR. JULIANNE STRAUSS CUSICK DPT, PT, COMT

Table of content: DR. JULIANNE STRAUSS CUSICK DPT, PT, COMT (NPI 1508169582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508169582 NPI number — DR. JULIANNE STRAUSS CUSICK DPT, PT, COMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUSICK
Provider First Name:
JULIANNE
Provider Middle Name:
STRAUSS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPT, PT, COMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STRAUSS
Provider Other First Name:
JULIANNE
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508169582
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19441 GOLF VISTA PL
Provider Second Line Business Mailing Address:
SUITE 340
Provider Business Mailing Address City Name:
LEESBURGH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-8272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-723-9527
Provider Business Mailing Address Fax Number:
703-723-4475

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19441 GOLF VISTA PLAZA
Provider Second Line Business Practice Location Address:
SUITE 340
Provider Business Practice Location Address City Name:
LEESBURGH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-8272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-723-9527
Provider Business Practice Location Address Fax Number:
703-723-4475
Provider Enumeration Date:
12/13/2010

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: 225100000X , with the licence number:  2305206714 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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