MEDICARE: DR. LEE ANN M. KLAUSNER MD

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
1	207YS0123X	Facial Plastic Surgery Physician	215036	NY

General Provider Information

NPI Number	:	1316929755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE ANN M. KLAUSNER MD

Provider Business Mailing Address
First Line	:	154 E 85TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-2103
Country	:	US
Telephone Number	:	212-288-1011
Fax Number	:	212-288-8082

Provider Business Practice Location Address
First Line	:	154 E 85TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-2103
Country	:	US
Telephone Number	:	212-288-1011
Fax Number	:	212-288-8082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/08/2007

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