Mrs Susan Jodie Kraus, MSRD | |
12-22 Sumner Pl, Fair Lawn, NJ 07410-4223 | |
(551) 206-2126 | |
Not Available |
Full Name | Mrs Susan Jodie Kraus |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 12-22 Sumner Pl, Fair Lawn, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285946665 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
133VN1006X | Dietitian, Registered - Nutrition, Metabolic | (* (Not Available)) | Secondary |
Provider Name | Hackensack Meridian Health Medical Group - Specialty Care Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1215989249 PECOS PAC ID: 9133032519 Enrollment ID: O20031111000524 |
Mailing Address | Practice Location Address |
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Mrs Susan Jodie Kraus, MSRD 12-22 Sumner Pl, Fair Lawn, NJ 07410-4223 Ph: (551) 206-2126 | Mrs Susan Jodie Kraus, MSRD 12-22 Sumner Pl, Fair Lawn, NJ 07410-4223 Ph: (551) 206-2126 |
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