Organization
JEFFREY KRAUSHAAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY KRAUSHAAR O.D. (OWNER/OPTOMETRIST)
(631) 821-2244
Entity
Organization
Contact information
Practice address
45 ROUTE 25A, SUITE 25A, SHOREHAM, NY 11786-1389
(631) 821-2244
Mailing address
45 ROUTE 25A, SUITE F, SHOREHAM, NY 11786-1389
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
VUT004145
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008871056
—
NY
01
—
410004627
RR MEDICARE
NY
01
—
C31421
EMPIRE HEALTHCHOICE
NY
Enumeration date
02/07/2008
Last updated
02/29/2008
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