Provider Demographics
NPI:1982707238
Name:KRAUS, DAVID MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:KRAUS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 JACOBS LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2654
Mailing Address - Country:US
Mailing Address - Phone:203-906-6164
Mailing Address - Fax:203-364-9680
Practice Address - Street 1:212 UNIVERSAL DR N
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3143
Practice Address - Country:US
Practice Address - Phone:203-906-6164
Practice Address - Fax:203-364-9680
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT2582152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004225810Medicaid
CT004225810Medicaid
CTU86300Medicare UPIN