Provider Demographics
NPI:1871862896
Name:KRAUSE, THOMAS MARTIN (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MARTIN
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 BRISTOL PIKE
Mailing Address - Street 2:
Mailing Address - City:CROYDON
Mailing Address - State:PA
Mailing Address - Zip Code:19021-5450
Mailing Address - Country:US
Mailing Address - Phone:215-785-5920
Mailing Address - Fax:215-785-5921
Practice Address - Street 1:314 BRISTOL PIKE
Practice Address - Street 2:
Practice Address - City:CROYDON
Practice Address - State:PA
Practice Address - Zip Code:19021-5450
Practice Address - Country:US
Practice Address - Phone:215-785-5920
Practice Address - Fax:215-785-5921
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician