Provider Demographics
NPI:1003865270
Name:KRAUSS, BARUCH SHLOMO (MD, EDM)
Entity Type:Individual
Prefix:DR
First Name:BARUCH
Middle Name:SHLOMO
Last Name:KRAUSS
Suffix:
Gender:M
Credentials:MD, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:DIVISION OF EMERGENCY MEDICINE, CHILDREN'S HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-4519
Mailing Address - Country:US
Mailing Address - Phone:617-355-4049
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:DIVISION OF EMERGENCY MEDICINE, CHILDREN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-4519
Practice Address - Country:US
Practice Address - Phone:617-355-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57132208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3045230Medicaid
MA3045230Medicaid
D87929Medicare UPIN