Provider Demographics
NPI:1073971222
Name:KRAUS, BETH (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:KRAUS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 HUDSON MANOR TER
Mailing Address - Street 2:APT 6K
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1105
Mailing Address - Country:US
Mailing Address - Phone:781-420-9082
Mailing Address - Fax:
Practice Address - Street 1:3801 HUDSON MANOR TER
Practice Address - Street 2:APT 6K
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1105
Practice Address - Country:US
Practice Address - Phone:781-420-9082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016978235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist