Provider Demographics
NPI:1982056941
Name:KRAUSE, TEALE (MS)
Entity Type:Individual
Prefix:
First Name:TEALE
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 QUAKERBRIDGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1200
Mailing Address - Country:US
Mailing Address - Phone:609-584-0790
Mailing Address - Fax:609-584-0595
Practice Address - Street 1:3535 QUAKERBRIDGE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1200
Practice Address - Country:US
Practice Address - Phone:609-584-0790
Practice Address - Fax:609-584-0595
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable