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 707
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-0707
Mailing Address - Country:US
Mailing Address - Phone:908-412-9599
Mailing Address - Fax:908-753-6226
Practice Address - Street 1:35 PROGRESS ST # 37
Practice Address - Street 2:SUITE B-1
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-412-9599
Practice Address - Fax:908-753-6226
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2013-10-15
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
NJMA63223207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG19629Medicare UPIN
NJ806657Medicare ID - Type Unspecified