Provider Demographics
NPI:1205693892
Name:ASHLEY, JULIA ALLISON CYRILLA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ALLISON CYRILLA
Last Name:ASHLEY
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 1:114 RIVERWALK WAY UNIT 9
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-3336
Mailing Address - Country:US
Mailing Address - Phone:518-590-4341
Mailing Address - Fax:
Practice Address - Street 1:711 TROY SCHENECTADY RD STE 216
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2461
Practice Address - Country:US
Practice Address - Phone:518-786-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08041412Medicaid