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NPI Code Detail

MEDICARE: DR. BRUCE DAVID KLASKIN D.O.

MEDICARE: DR. BRUCE DAVID KLASKIN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianOS003067-LPA
2208VP0000XPain Medicine PhysicianOS003067-LPA

General Provider Information

NPI Number : 1578556536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE DAVID KLASKIN D.O.
Provider Business Mailing Address
First Line : 1776 S QUEEN ST
Second Line :
City : YORK
State : PA
Zip : 17403-4628
Country : US
Telephone Number : 717-845-3335
Fax Number : 717-845-3995
Provider Business Practice Location Address
First Line : 1776 S QUEEN ST
Second Line :
City : YORK
State : PA
Zip : 17403-4628
Country : US
Telephone Number : 717-845-3335
Fax Number : 717-845-3995
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 01/26/2010

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