Provider Demographics
NPI:1003083312
Name:KAUS, SHARON M (DO)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:KAUS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 LIBERTY PL
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5710
Mailing Address - Country:US
Mailing Address - Phone:856-885-4854
Mailing Address - Fax:
Practice Address - Street 1:1303 LIBERTY PL
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5710
Practice Address - Country:US
Practice Address - Phone:856-885-4854
Practice Address - Fax:856-968-8414
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08379900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01004664100OtherAMERICHOICE
NJP3922107OtherOXFORD
NJ1879505/9110165OtherAETNA
NJ0167193Medicaid
NJ3531619000OtherAMERIHEALTH/KEYSTONE/IBC
NJ60042703OtherHORIZON NJ HEALTH
NJ124964 MB5Medicare PIN