1083790448 NPI number — ANDREW CHARLES KLEIN PT

Table of content: ANDREW CHARLES KLEIN PT (NPI 1083790448)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083790448 NPI number — ANDREW CHARLES KLEIN PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEIN
Provider First Name:
ANDREW
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083790448
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
174 GRAND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10601-4803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-328-8077
Provider Business Mailing Address Fax Number:
914-328-6083

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
176 GRAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10601-4803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-328-6080
Provider Business Practice Location Address Fax Number:
914-328-6081
Provider Enumeration Date:
10/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  003778 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0401995 . This is a "CIGNA-ORTHONET TUCKAHOE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401997 . This is a "AETNA-ORTHONET MCLEAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401997 . This is a "CIGNA-ORTHONET MCLEAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 272438120 . This is a "HUDSON HEALTH PLAN-GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401997 . This is a "US FAMILY-ORTHONET MCLEAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 03282455 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 123832P . This is a "EMBLEM HEALTH/GHI/HIP/PPO/POS/EPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2343974 . This is a "HUMANA-GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PT003778A-05 . This is a "HEALTH FIRST -GRP ID: 272438129-001" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 272438120 . This is a "FPN-GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4412422 . This is a "AETNA LOCAL SEUI 1199" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 786980 . This is a "OPTUMN PHYSICAL THERAPY-GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 272438120 . This is a "POMCO-GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401995 . This is a "AETNA-ORTHONET TUCKAHOE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0401995 . This is a "US FAMILY-ORTHONET TUCKAHOE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: ASC-616130500 . This is a "FECA/OFFICE OF WORKERS COMPENSATION PROGRAMS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01827690 . This is a "AMERIGROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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