Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 215036 | NY |
NPI | 1316929755 |
---|---|
Provider Name | Dr. Lee Ann M. Klausner |
First Address | New York, NY 10028-2103 |
Second Address | New York, NY 10028-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I04216 | (02) | NY |