Provider Demographics
NPI:1588845820
Name:KAUS, DENICE MICHELE (RPH)
Entity Type:Individual
Prefix:
First Name:DENICE
Middle Name:MICHELE
Last Name:KAUS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-3572
Mailing Address - Country:US
Mailing Address - Phone:716-366-2624
Mailing Address - Fax:855-331-9047
Practice Address - Street 1:3955 VINEYARD DR
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-3572
Practice Address - Country:US
Practice Address - Phone:716-366-2624
Practice Address - Fax:855-331-9047
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02842900Medicaid
NY045323OtherUNIVERSITY OF NY EDUCATION DEPARTMENT OFFICE OF PROFESSIONS