Provider Demographics
NPI:1356877146
Name:MINZNER, JULIE (PHARMD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MINZNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 TOPSHAM FAIR MALL RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1734
Mailing Address - Country:US
Mailing Address - Phone:207-729-3800
Mailing Address - Fax:
Practice Address - Street 1:49 TOPSHAM FAIR MALL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1734
Practice Address - Country:US
Practice Address - Phone:207-729-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist