Basic Information
Provider Information
NPI: 1396769691
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRAUSS
FirstName: KENNETH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 316 E 30TH ST
Address2: 2ND FLOOR
City: NEW YORK
State: NY
PostalCode: 100168366
CountryCode: US
TelephoneNumber: 2126140039
FaxNumber: 2122539631
Practice Location
Address1: 38 E 32ND ST
Address2: 8TH FLOOR
City: NEW YORK
State: NY
PostalCode: 100165507
CountryCode: US
TelephoneNumber: 2126843305
FaxNumber: 2126844775
Other Information
ProviderEnumerationDate: 07/27/2006
LastUpdateDate: 10/03/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X108352NYY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


Home