Provider Demographics
NPI:1518982982
Name:KLAUSNER, ERIC G (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:G
Last Name:KLAUSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:99 E STATE ST
Mailing Address - Street 2:PO BOX 1250
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1203
Mailing Address - Country:US
Mailing Address - Phone:518-883-8620
Mailing Address - Fax:518-883-5653
Practice Address - Street 1:4104 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6202
Practice Address - Country:US
Practice Address - Phone:518-883-8620
Practice Address - Fax:518-883-5653
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY180976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01279161Medicaid
NYF21610Medicare UPIN
NYRA7649Medicare PIN