MEDICARE: DR. LESLEY KRAUS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	270A00570800	NJ

General Provider Information

NPI Number	:	1104829795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLEY KRAUS OD

Provider Business Mailing Address
First Line	:	PO BOX 2089444
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-0001
Country	:	US
Telephone Number	:	636-200-4393
Fax Number	:	636-527-0766

Provider Business Practice Location Address
First Line	:	3013 HWY 35
Second Line	:
City	:	HAZLET
State	:	NJ
Zip	:	07730
Country	:	US
Telephone Number	:	732-739-4000
Fax Number	:	732-739-4002

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	11/19/2022

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