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General NPI Number Information
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NPI Number | 1912185950
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Entity Type | Organization
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Legal Business Name | DR LAWRENCE JOSEPH KRUSE OD
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 1421 KIRKWOOD HIGHWAY SUITE 1106
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City | NEWARK
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State | DE
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Zip | 19711-5705
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Country | US
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Telephone | 302-731-7132
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Fax | 301-731-7132
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Provider Business Mailing Address
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Address Line | 1421 KIRKWOOD HIGHWAY SUITE 1106 POLLY DRYMMOND OFFICE PARK
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City | NEWARK
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State | DE
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Zip | 19711-5705
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Country | US
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Telephone | 302-731-7132
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Fax | 301-731-7132
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Authorized Official
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Title or Position | DR
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Name | DR. LAWRENCE JOSEPH KRUSE
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Credential | OD
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Telephone | 302-731-7132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | I30001125
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License Number State | DE
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