Basic Information
| Provider Information | |||||||||
| NPI: | 1396988697 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRAUS | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | CARSON | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CARSON | ||||||||
| OtherFirstName: | KATHERINE | ||||||||
| OtherMiddleName: | LECKER | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 180 FORT WASHINGTON AVENUE | ||||||||
| Address2: | SUITE 242 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123263399 | ||||||||
| FaxNumber: | 2123051754 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 FORT WASHINGTON AVENUE | ||||||||
| Address2: | SUITE 242 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123263399 | ||||||||
| FaxNumber: | 2123051754 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2009 | ||||||||
| LastUpdateDate: | 04/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 260472 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.