Provider Demographics
NPI:1013019801
Name:RAUGELLIS, PAULA F, (DPM)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:F,
Last Name:RAUGELLIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 ELM DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-8269
Mailing Address - Country:US
Mailing Address - Phone:724-852-2255
Mailing Address - Fax:724-627-5540
Practice Address - Street 1:246 ELM DR
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8269
Practice Address - Country:US
Practice Address - Phone:724-852-2255
Practice Address - Fax:724-627-5540
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-002771-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30501Medicare UPIN
PARA449352Medicare ID - Type Unspecified