Provider Demographics
NPI:1134108814
Name:VALUCH, JILL ELAINE (DO)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:ELAINE
Last Name:VALUCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:317 COPLEY DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2974
Mailing Address - Country:US
Mailing Address - Phone:717-569-3018
Mailing Address - Fax:717-569-3903
Practice Address - Street 1:1725 OREGON PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4206
Practice Address - Country:US
Practice Address - Phone:717-569-8518
Practice Address - Fax:717-569-3903
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006451L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics