Basic Information
| Provider Information | |||||||||
| NPI: | 1558358408 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEPANIAN | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | LOPES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 BROADWAY | ||||||||
| Address2: | SOMERVILLE PEDIATRICS | ||||||||
| City: | SOMERVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021452935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172847000 | ||||||||
| FaxNumber: | 6172847080 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 BROADWAY | ||||||||
| Address2: | SOMERVILLE PEDIATRICS | ||||||||
| City: | SOMERVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021452935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172847000 | ||||||||
| FaxNumber: | 6172847080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ML0378352A | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.