MEDICARE: DINA KRAUSZ MS

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	222Q00000X	Developmental Therapist	967468151	NY

General Provider Information

NPI Number	:	1720639289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINA KRAUSZ MS

Provider Business Mailing Address
First Line	:	4201 FORT HAMILTON PKWY APT 6R
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1273
Country	:	US
Telephone Number	:	718-435-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	4511 14TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2107
Country	:	US
Telephone Number	:	718-851-1212
Fax Number	:

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

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	09/26/2019

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