Provider Demographics
NPI:1952395683
Name:KLUGER, ALAN J (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:KLUGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 NORTHERN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5309
Mailing Address - Country:US
Mailing Address - Phone:516-466-4227
Mailing Address - Fax:
Practice Address - Street 1:935 NORTHERN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5309
Practice Address - Country:US
Practice Address - Phone:516-466-4227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142537207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB14702Medicare UPIN
NY44D171Medicare ID - Type Unspecified