Provider Demographics
NPI:1942274550
Name:KRAUSE, PETER (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:KRAUSE
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 1:60 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3201
Mailing Address - Country:US
Mailing Address - Phone:203-785-3223
Mailing Address - Fax:203-785-3604
Practice Address - Street 1:60 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3201
Practice Address - Country:US
Practice Address - Phone:203-785-3223
Practice Address - Fax:203-785-3604
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0210072080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001210079Medicaid
CT370000980Medicare ID - Type Unspecified
CT001210079Medicaid