=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154537462
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH SUE VAN AULEN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 334 HARTMAN BRIDGE RD
-----------------------------------------------------
City | RONKS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17572-9508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-687-2082
-----------------------------------------------------
Fax | 717-983-4723
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 334 HARTMAN BRIDGE RD
-----------------------------------------------------
City | RONKS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17572-9508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-687-2082
-----------------------------------------------------
Fax | 717-983-4723
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD438444
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------