Provider Demographics
NPI:1336123959
Name:KLAGER, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:KLAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 W 91ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1132
Mailing Address - Country:US
Mailing Address - Phone:212-595-7200
Mailing Address - Fax:212-595-1630
Practice Address - Street 1:260 W 91ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1132
Practice Address - Country:US
Practice Address - Phone:212-595-7200
Practice Address - Fax:212-595-1630
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00423818Medicaid
0099630OtherGHI
NP1416OtherOXFORD
169627POtherHIP
19A201Medicare ID - Type Unspecified
NY00423818Medicaid