Provider Demographics
NPI:1871571000
Name:YUSKOVIC, PAMELA JANE (PA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JANE
Last Name:YUSKOVIC
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 SCHAPER AVENUE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-3360
Mailing Address - Country:US
Mailing Address - Phone:814-868-0943
Mailing Address - Fax:814-866-1160
Practice Address - Street 1:3822 SCHAPER AVENUE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-3360
Practice Address - Country:US
Practice Address - Phone:814-868-0943
Practice Address - Fax:814-866-1160
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001890L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant