Provider Demographics
NPI:1427136530
Name:KLUFAS RYALL, ULANA (DO)
Entity type:Individual
Prefix:MRS
First Name:ULANA
Middle Name:
Last Name:KLUFAS RYALL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2618
Mailing Address - Country:US
Mailing Address - Phone:717-849-5473
Mailing Address - Fax:
Practice Address - Street 1:1784 4TH AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2618
Practice Address - Country:US
Practice Address - Phone:717-849-5473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008774L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS008774LOtherSTATE LICENSE NUMBER
PAG68316Medicare UPIN