Provider Demographics
NPI:1912167024
Name:STRAUSS, KATHLEEN M (DC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:STRAUSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 OCEAN AVE N
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-7581
Mailing Address - Country:US
Mailing Address - Phone:732-229-2228
Mailing Address - Fax:732-229-1243
Practice Address - Street 1:238 OCEAN AVE N
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-7581
Practice Address - Country:US
Practice Address - Phone:732-229-2228
Practice Address - Fax:732-229-1243
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00271800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1577905Medicaid
NJST452744Medicare UPIN