Provider Demographics
NPI:1316929755
Name:KLAUSNER, LEE ANN M (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANN M
Last Name:KLAUSNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 E 85TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2103
Mailing Address - Country:US
Mailing Address - Phone:212-288-1011
Mailing Address - Fax:212-288-8082
Practice Address - Street 1:154 E 85TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2103
Practice Address - Country:US
Practice Address - Phone:212-288-1011
Practice Address - Fax:212-288-8082
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215036207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI04216Medicare UPIN
NY7M4591Medicare ID - Type Unspecified