1639619075 NPI number — MRS. LAUREN ROSA KLUESENER NP-BC

Table of content: MRS. LAUREN ROSA KLUESENER NP-BC (NPI 1639619075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639619075 NPI number — MRS. LAUREN ROSA KLUESENER NP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLUESENER
Provider First Name:
LAUREN
Provider Middle Name:
ROSA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSA
Provider Other First Name:
LAUREN
Provider Other Middle Name:
AILEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639619075
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 E 41ST STREET
Provider Second Line Business Mailing Address:
7TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-425-8000
Provider Business Mailing Address Fax Number:
212-203-8885

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 E 41ST STREET
Provider Second Line Business Practice Location Address:
7TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-425-8000
Provider Business Practice Location Address Fax Number:
212-203-8885
Provider Enumeration Date:
03/05/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0200X , with the licence number:  708952 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: F342668-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 342668 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)