Provider Information for 1972056711
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JULIA GAW
Sex: Female
NPI: 1972056711
Last Updated: 2024-10-02
Certification Date: 2024-10-02
Certification Date: 2024-10-02
Details
Name | Value | ||||||||||||||||
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NPI | 1972056711 | ||||||||||||||||
Enumeration Date | 2016-07-28 | ||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||
Sole Proprietor | NO | ||||||||||||||||
Status | Active | ||||||||||||||||
Mailing Address | 70 HOOD AVE RUMFORD, RI 02916-1545 United States Phone: 973-809-8253 | Fax:401-253-0003 | ||||||||||||||||
Primary Practice Address | 70 HOOD AVE RUMFORD, RI 02916-1545 United States Phone: 973-809-8253 | Fax:401-253-0003 | ||||||||||||||||
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