Provider Demographics
NPI:1750637377
Name:KLAUSNER, MICHAEL (MS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:KLAUSNER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 CENTRAL AVE
Mailing Address - Street 2:APT 208
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4650
Mailing Address - Country:US
Mailing Address - Phone:718-734-8871
Mailing Address - Fax:
Practice Address - Street 1:1261 CENTRAL AVE
Practice Address - Street 2:APT 208
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4650
Practice Address - Country:US
Practice Address - Phone:718-734-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist