Provider Demographics
NPI:1922113281
Name:KRAUSZ, DANIELA A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:A
Last Name:KRAUSZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5044
Mailing Address - Country:US
Mailing Address - Phone:573-472-7492
Mailing Address - Fax:573-472-7740
Practice Address - Street 1:7170 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034
Practice Address - Country:US
Practice Address - Phone:215-641-5300
Practice Address - Fax:215-641-6815
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4301222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209156801Medicaid
MO209156801Medicaid
000090699Medicare ID - Type UnspecifiedINDIVIDUAL MCR NUMBER