MEDICARE: RICHARD PHILIP KLUFT M.D.

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	2084P0800X	Psychiatry Physician	MD-011120E	PA

General Provider Information

NPI Number	:	1619097581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD PHILIP KLUFT M.D.

Provider Business Mailing Address
First Line	:	111 PRESIDENTIAL BLVD
Second Line	:	SUITE 238
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1008
Country	:	US
Telephone Number	:	610-667-3250
Fax Number	:	610-667-3374

Provider Business Practice Location Address
First Line	:	111 PRESIDENTIAL BLVD
Second Line	:	SUITE 238
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1008
Country	:	US
Telephone Number	:	610-667-3250
Fax Number	:	610-667-3374

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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