Provider Demographics
NPI:1487852778
Name:KRAUS, GERALD (DC)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:KRAUS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 JORALEMON ST
Mailing Address - Street 2:APT# 39
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1433
Mailing Address - Country:US
Mailing Address - Phone:678-361-7401
Mailing Address - Fax:
Practice Address - Street 1:2526 SHALLOWFORD RD
Practice Address - Street 2:SUITE. D
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3053
Practice Address - Country:US
Practice Address - Phone:770-928-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007345111N00000X
NJMC 05384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV04903Medicare UPIN
GA35ZCJFDMedicare ID - Type UnspecifiedGEORGIA MEDICARE PART.B
GAP00355824Medicare ID - Type UnspecifiedRAILROAD MEDICARE