Provider Demographics
NPI:1649350117
Name:KLUGMAN, SUSAN D (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:D
Last Name:KLUGMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1695 EASTCHESTER RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2374
Mailing Address - Country:US
Mailing Address - Phone:718-405-8150
Mailing Address - Fax:718-405-8154
Practice Address - Street 1:LARCHMONT WOMEN'S CENTER
Practice Address - Street 2:2345 BOSTON POST ROAD
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538
Practice Address - Country:US
Practice Address - Phone:914-833-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY184331207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)