Provider Demographics
NPI:1770224172
Name:AUKES-JANOSCRAT, EMILY JANE (PHDHP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JANE
Last Name:AUKES-JANOSCRAT
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 ARROWHEAD WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-7042
Mailing Address - Country:US
Mailing Address - Phone:160-776-0440
Mailing Address - Fax:
Practice Address - Street 1:136 ARROWHEAD WAY
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-7042
Practice Address - Country:US
Practice Address - Phone:160-776-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH0003581223D0001X
PADH068133124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1200000XMedicaid