Provider Demographics
NPI:1265454961
Name:KRAUS, ELLIOTT M (MD)
Entity type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:M
Last Name:KRAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:76 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205
Mailing Address - Country:US
Mailing Address - Phone:609-404-1200
Mailing Address - Fax:609-404-1205
Practice Address - Street 1:76 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 301
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205
Practice Address - Country:US
Practice Address - Phone:609-404-1200
Practice Address - Fax:609-404-1205
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA28720208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3474305Medicaid
NJ3474305Medicaid
520405Medicare ID - Type Unspecified