Provider Demographics
NPI:1801822994
Name:REAL, JULIE C (PT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:REAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WILMOR DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1305
Mailing Address - Country:US
Mailing Address - Phone:609-371-2133
Mailing Address - Fax:
Practice Address - Street 1:476 AMWELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-3400
Practice Address - Country:US
Practice Address - Phone:908-281-6515
Practice Address - Fax:908-281-6269
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00998000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation