Individual provider Active NPI

Julia Ann Andrechuk

  • Registered Nurse
  • Holbrook, NY
National Provider Identifier
1013490440
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
806035 Issued in NY
Practice address
31 Westbridge Dr
Holbrook, NY 11741-5309
Phone
(631) 495-8708
NPI assigned
Sep 11, 2018
Reactivated
Jan 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 806035 NY Primary

Addresses

Primary practice location

31 Westbridge Dr
Holbrook, NY 11741-5309

Mailing address

31 Westbridge Dr
Holbrook, NY 11741-5309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
806035NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1013490440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WESTBRIDGE DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WESTBRIDGE DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415309",
            "telephone_number": "631-495-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRECHUK",
        "first_name": "JULIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "deactivation_date": "2021-06-21",
        "reactivation_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "806035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.