Healthcare Provider Details

I. General information

NPI: 1962364448
Provider Name (Legal Business Name): ARNOLD JAY KLUGMAN AEMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BRADBURY WAY
CUMBERLAND ME
04021-3661
US

IV. Provider business mailing address

366 TUTTLE RD
CUMBERLAND ME
04021-3627
US

V. Phone/Fax

Practice location:
  • Phone: 207-829-5421
  • Fax:
Mailing address:
  • Phone: 207-829-5421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number29725
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: