Provider Demographics
NPI:1144548132
Name:LIM, JULIUS EMMANUEL (PT)
Entity type:Individual
Prefix:MR
First Name:JULIUS EMMANUEL
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2564 127TH ST
Mailing Address - Street 2:1ST FLR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1129
Mailing Address - Country:US
Mailing Address - Phone:562-221-2156
Mailing Address - Fax:
Practice Address - Street 1:2564 127TH ST
Practice Address - Street 2:1ST FLR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1129
Practice Address - Country:US
Practice Address - Phone:562-221-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032454225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY032454OtherPT NY LICENSE NUMBER