Provider Demographics
NPI:1760545420
Name:KLAUSNER, LLOYD KENNETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:KENNETH
Last Name:KLAUSNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 DEEPWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1624
Mailing Address - Country:US
Mailing Address - Phone:516-484-7388
Mailing Address - Fax:646-264-0015
Practice Address - Street 1:30 CENTRAL PARK S
Practice Address - Street 2:SUITE 3C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1628
Practice Address - Country:US
Practice Address - Phone:212-888-8889
Practice Address - Fax:646-264-0015
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0421661223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD5I781Medicare ID - Type Unspecified