Provider Demographics
NPI:1851691356
Name:KRAUS, SARAH (LAC, CD(DONA), LMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KRAUS
Suffix:
Gender:F
Credentials:LAC, CD(DONA), LMT
Other - Prefix:
Other - First Name:TZIVYA
Other - Middle Name:
Other - Last Name:KRAUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1212 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3018
Mailing Address - Country:US
Mailing Address - Phone:267-808-3399
Mailing Address - Fax:
Practice Address - Street 1:1212 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-3018
Practice Address - Country:US
Practice Address - Phone:267-808-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-30
Last Update Date:2010-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004430-1171100000X
PAAK000989171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist