Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 254536 | NY |
N | 207K00000X | Allergist & Immunologist | 25MA08984900 | NJ |
NPI | 1023242377 |
---|---|
Provider Name | Dr. Julie Susan Kuriakose |
First Address | Watchung, NJ 07069-5815 |
Second Address | Somerset, NJ 08873-1693 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 24/02/2012 |