Basic Information
| Provider Information | |||||||||
| NPI: | 1003083312 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUS | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1303 LIBERTY PL | ||||||||
| Address2: | |||||||||
| City: | SICKLERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080815710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568854854 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1303 LIBERTY PL | ||||||||
| Address2: | |||||||||
| City: | SICKLERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080815710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568854854 | ||||||||
| FaxNumber: | 8569688414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2008 | ||||||||
| LastUpdateDate: | 04/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MB08379900 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 01004664100 | 01 | NJ | AMERICHOICE | OTHER | P3922107 | 01 | NJ | OXFORD | OTHER | 1879505/9110165 | 01 | NJ | AETNA | OTHER | 0167193 | 05 | NJ | MEDICAID | 3531619000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 60042703 | 01 | NJ | HORIZON NJ HEALTH | OTHER |