=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467477299
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN L STRAUS MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2006
-----------------------------------------------------
Last Update Date | 09/27/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 255 W LANCASTER AVE
-----------------------------------------------------
City | PAOLI
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19301-1763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-565-1601
-----------------------------------------------------
Fax | 484-565-2006
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1020A EAST BOAL AVENUE
-----------------------------------------------------
City | BOALSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16827-1530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-237-8627
-----------------------------------------------------
Fax | 814-238-0083
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0001X
-----------------------------------------------------
Taxonomy Name | Radiation Oncology Physician
-----------------------------------------------------
License Number | 0101046179
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2085R0001X
-----------------------------------------------------
Taxonomy Name | Radiation Oncology Physician
-----------------------------------------------------
License Number | MD030414E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------