Provider Demographics
NPI:1932389848
Name:KLAHR, RAIZY (PA)
Entity Type:Individual
Prefix:
First Name:RAIZY
Middle Name:
Last Name:KLAHR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:KLAHR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5204
Mailing Address - Country:US
Mailing Address - Phone:845-357-7277
Mailing Address - Fax:845-357-5516
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 109
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5204
Practice Address - Country:US
Practice Address - Phone:845-357-7277
Practice Address - Fax:845-357-5516
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007091363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical