Provider Demographics
NPI:1538196993
Name:HAUSER, JULIE ANN (OD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:HAUSER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2501 W 12TH ST
Mailing Address - Street 2:YORKTOWN CENTRE
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4527
Mailing Address - Country:US
Mailing Address - Phone:814-838-0550
Mailing Address - Fax:814-835-0576
Practice Address - Street 1:2501 W 12TH ST
Practice Address - Street 2:YORKTOWN CENTRE
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4527
Practice Address - Country:US
Practice Address - Phone:814-838-0550
Practice Address - Fax:814-835-0576
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE007024T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU22899Medicare UPIN
PA680781Medicare PIN
PA1109790001Medicare NSC