1912394081 NPI number — JULIANNE M FORLIZZI MD

Table of content: JULIANNE M FORLIZZI MD (NPI 1912394081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912394081 NPI number — JULIANNE M FORLIZZI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORLIZZI
Provider First Name:
JULIANNE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1912394081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 ROBERT WOOD JOHNSON PL
Provider Second Line Business Mailing Address:
DEPARTMENT OF ORTHOPAEDIC SURGERY, MEB 424
Provider Business Mailing Address City Name:
NEW BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08901-1928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-235-7689
Provider Business Mailing Address Fax Number:
732-235-6002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
761 MAIN AVE STE 115
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06851-1080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-845-2200
Provider Business Practice Location Address Fax Number:
203-847-1940
Provider Enumeration Date:
04/16/2015

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: 68988 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com