Provider Demographics
NPI:1083636898
Name:KRUSE, CHRISTOPHER BRYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRYANT
Last Name:KRUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:225 HIGHWAY 35 STE 208
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5919
Mailing Address - Country:US
Mailing Address - Phone:732-747-5500
Mailing Address - Fax:877-843-7654
Practice Address - Street 1:225 HIGHWAY 35 STE 208
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5919
Practice Address - Country:US
Practice Address - Phone:732-747-5500
Practice Address - Fax:877-843-7654
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA70846207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG95643Medicare UPIN
NJ050373Medicare ID - Type Unspecified