Provider Demographics
NPI:1902808991
Name:KRAUS, WARREN M (MD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:M
Last Name:KRAUS
Suffix:
Gender:M
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:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:575 ROUTE 28 STE 3107
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1363
Practice Address - Country:US
Practice Address - Phone:908-947-2721
Practice Address - Fax:908-947-2719
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2024-06-12
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06322300207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG19629Medicare UPIN
NJ806657Medicare ID - Type Unspecified