Provider Demographics
NPI:1639619075
Name:KLUESENER, LAUREN ROSA (NP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ROSA
Last Name:KLUESENER
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:AILEEN
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-BC
Mailing Address - Street 1:222 E 41ST STREET
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-425-8000
Mailing Address - Fax:212-203-8885
Practice Address - Street 1:222 E 41ST STREET
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-425-8000
Practice Address - Fax:212-203-8885
Is Sole Proprietor?:No
Enumeration Date:2017-03-05
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY708952163WP0200X
NYF342668-1363LF0000X
NY342668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics