Provider Demographics
NPI:1346412012
Name:KLAUSNER, MARK A
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:KLAUSNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2332 TOWN CT N
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4709
Mailing Address - Country:US
Mailing Address - Phone:609-462-9217
Mailing Address - Fax:
Practice Address - Street 1:2332 TOWN CT N
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4709
Practice Address - Country:US
Practice Address - Phone:609-462-9217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05024400207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology