Individual
JONATHAN KLUGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2595
(651) 254-3456
Mailing address
333 CEDAR ST, NEW HAVEN, CT 06510-3206
(203) 432-4771
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018790646
DRIVER'S LICENSE
CT
Enumeration date
03/06/2023
Last updated
06/04/2024
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