Provider Demographics
NPI:1861760589
Name:KRAUS, PEGGY KAREN (CDE RCEP)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:KAREN
Last Name:KRAUS
Suffix:
Gender:F
Credentials:CDE RCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:82 SPRINGVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2453
Mailing Address - Country:US
Mailing Address - Phone:631-728-5575
Mailing Address - Fax:
Practice Address - Street 1:349 MEETING HOUSE LN
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5051
Practice Address - Country:US
Practice Address - Phone:631-377-3630
Practice Address - Fax:631-377-3631
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor