Provider Demographics
NPI:1689857740
Name:RAUH, JILLIAN MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:MICHELLE
Last Name:RAUH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5525
Mailing Address - Country:US
Mailing Address - Phone:215-860-8331
Mailing Address - Fax:215-860-8332
Practice Address - Street 1:306 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5525
Practice Address - Country:US
Practice Address - Phone:215-860-8331
Practice Address - Fax:215-860-8332
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4225112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry