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NPI Code Detail

MEDICARE: DR LAWRENCE JOSEPH KRUSE OD

MEDICARE: DR LAWRENCE JOSEPH KRUSE 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
1152W00000XOptometristI30001125DE

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21073535571OTHERMEDICARE-NPI-SOLO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912185950
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR LAWRENCE JOSEPH KRUSE OD
Provider Business Mailing Address
First Line : 1421 KIRKWOOD HIGHWAY
Second Line : SUITE 1106 POLLY DRYMMOND OFFICE PARK
City : NEWARK
State : DE
Zip : 19711-5705
Country : US
Telephone Number : 302-731-7132
Fax Number : 301-731-7132
Provider Business Practice Location Address
First Line : 1421 KIRKWOOD HIGHWAY
Second Line : SUITE 1106
City : NEWARK
State : DE
Zip : 19711-5705
Country : US
Telephone Number : 302-731-7132
Fax Number : 301-731-7132
Authorized Official
Title or Position : DR
Name : DR. LAWRENCE JOSEPH KRUSE
Credential : OD
Telephone Number : 302-731-7132
Provider Enumeration Date : 02/01/2008
Last Update Date : 04/10/2008

Similar Medicare Providers

1073535571 — DR. LAWRENCE JOSEPH KRUSE OD
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Directions to “DR LAWRENCE JOSEPH KRUSE OD ” Practice Location

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