Healthcare Provider Details

I. General information

NPI: 1003083312
Provider Name (Legal Business Name): SHARON M KAUS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 LIBERTY PL
SICKLERVILLE NJ
08081-5710
US

IV. Provider business mailing address

1303 LIBERTY PL
SICKLERVILLE NJ
08081-5710
US

V. Phone/Fax

Practice location:
  • Phone: 856-885-4854
  • Fax: 856-968-8414
Mailing address:
  • Phone: 856-885-4854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB08379900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01004664100
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAMERICHOICE
# 2
IdentifierP3922107
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerOXFORD
# 3
Identifier1879505/9110165
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAETNA
# 4
Identifier0167193
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer
# 5
Identifier3531619000
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAMERIHEALTH/KEYSTONE/IBC
# 6
Identifier60042703
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerHORIZON NJ HEALTH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: