Provider Demographics
NPI:1043493885
Name:MING, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1791 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2120
Mailing Address - Country:US
Mailing Address - Phone:718-241-3559
Mailing Address - Fax:718-451-3537
Practice Address - Street 1:1791 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2120
Practice Address - Country:US
Practice Address - Phone:718-241-3559
Practice Address - Fax:718-451-3537
Is Sole Proprietor?:No
Enumeration Date:2007-12-16
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049009-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01712481Medicaid