Basic Information
Provider Information
NPI: 1336156876
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JULIAN
FirstName: ANN MARIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CIOFFI
OtherFirstName: ANN MARIE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 5
Mailing Information
Address1: PO BOX 9805
Address2: 300 GEORGE ST 6TH FLR
City: NEW HAVEN
State: CT
PostalCode: 065360805
CountryCode: US
TelephoneNumber: 2037857998
FaxNumber: 2037856414
Practice Location
Address1: 800 HOWARD AVE
Address2: YALE PHYSICIANS BLDG
City: NEW HAVEN
State: CT
PostalCode: 065191369
CountryCode: US
TelephoneNumber: 2037852140
FaxNumber: 2037856414
Other Information
ProviderEnumerationDate: 08/01/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X001859CTY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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