Provider Demographics
NPI:1316962533
Name:MILANAK, JULIA DAWN (OD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:DAWN
Last Name:MILANAK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-1001
Mailing Address - Country:US
Mailing Address - Phone:814-201-2423
Mailing Address - Fax:814-201-2444
Practice Address - Street 1:6031 6TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-1001
Practice Address - Country:US
Practice Address - Phone:814-201-2423
Practice Address - Fax:814-201-2444
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000688152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001151968Medicaid
PA000553214OtherBCBS MILANAK
PA000553214OtherBCBS MILANAK