Healthcare Provider Details

I. General information

NPI: 1457598112
Provider Name (Legal Business Name): CHRISTOPHER B. KRUSE, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 STATE ROUTE 35 STE 208
RED BANK NJ
07701-5919
US

IV. Provider business mailing address

225 STATE ROUTE 35 STE 208
RED BANK NJ
07701-5919
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-5500
  • Fax: 732-747-1212
Mailing address:
  • Phone: 732-747-5500
  • Fax: 732-747-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BRYANT KRUSE
Title or Position: PRESIDENT
Credential:
Phone: 973-641-4511