Basic Information
| Provider Information | |||||||||
| NPI: | 1457640435 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUNTER | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | KATHARINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 525 EAST MARKET STREET | ||||||||
| Address2: | SUMMA HEALTH SYSTEM | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303795083 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10-42 MITCHELL AVE | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139031617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077622990 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2011 | ||||||||
| LastUpdateDate: | 07/15/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 042.0012920 | VT | N | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | 35.125963 | OH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207QA0401X | 283914 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0143608 | 05 | OH | MEDICAID | 03960469 | 05 | NY | MEDICAID | 1023597 | 05 | VT | MEDICAID |