1720241045 NPI number — DR. JULIE ELIZABETH FURLAN D.O.

Table of content: DR. JULIE ELIZABETH FURLAN D.O. (NPI 1720241045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720241045 NPI number — DR. JULIE ELIZABETH FURLAN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FURLAN
Provider First Name:
JULIE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

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 Information

NPI Number:
1720241045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
984 WHITTIER HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOULTONBOROUGH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03254-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-476-2216
Provider Business Mailing Address Fax Number:
603-476-5396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
984 WHITTIER HIGHWAY
Provider Second Line Business Practice Location Address:
MOULTONBOROUGH FAMILY MEDICINE
Provider Business Practice Location Address City Name:
MOULTONBOROUGH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-476-2216
Provider Business Practice Location Address Fax Number:
603-476-5396
Provider Enumeration Date:
07/07/2008

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: 207Q00000X , with the licence number:  LL1161 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 15185 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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