Provider Demographics
NPI:1841397221
Name:KRAUSHAAR, BARRY S (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:S
Last Name:KRAUSHAAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 AIRPORT EXECUTIVE PARK
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5288
Mailing Address - Country:US
Mailing Address - Phone:845-425-0555
Mailing Address - Fax:845-426-6126
Practice Address - Street 1:408 AIRPORT EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-5288
Practice Address - Country:US
Practice Address - Phone:845-425-0555
Practice Address - Fax:845-426-6126
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191949-1207XX0005X, 207X00000X
NJ25MA06422500207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13359OtherGHI / MEDICARE
NY119040OtherCONSUMER HEALTH NETWORK
NY2C2813OtherPHS/HEALTHNET
NY4642420OtherCIGNA
NY5739261OtherAETNA/USHC-PPO/POS
NY0599965OtherGHI-FLEX SELECT
NY2182254OtherAETNA /USHC-HMO
NY71G501OtherEMPIRE BCBS/ NY
NYP441071OtherOXFORD/UNITED HEALTHCARE
NJ71G501OtherEMPIRE BC/BS-NJ
NY2C2813OtherPHS/HEALTHNET
NY0599965OtherGHI-FLEX SELECT
NYP441071OtherOXFORD/UNITED HEALTHCARE
NJ879971YNHEMedicare PIN