Provider Demographics
NPI:1912323759
Name:KRAUSE, SURI
Entity Type:Individual
Prefix:
First Name:SURI
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SYLVAN ROAD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:845-642-7993
Mailing Address - Fax:
Practice Address - Street 1:4 SYLVAN RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2922
Practice Address - Country:US
Practice Address - Phone:845-642-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00595300235Z00000X
NY018894-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist