Provider Demographics
NPI:1023016433
Name:KLUGER, MARTIN (PHD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:KLUGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4315
Mailing Address - Country:US
Mailing Address - Phone:201-092-9500
Mailing Address - Fax:201-692-0234
Practice Address - Street 1:175 CEDAR LN
Practice Address - Street 2:STE A
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4315
Practice Address - Country:US
Practice Address - Phone:201-092-9500
Practice Address - Fax:201-692-0234
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-09
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2133103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKL566628Medicare ID - Type Unspecified