1619296167 NPI number — MS. MONA SOPHIE NORMA KLING PHD, M.S.

Table of content: (NPI 1366811879)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619296167 NPI number — MS. MONA SOPHIE NORMA KLING PHD, M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLING
Provider First Name:
MONA SOPHIE
Provider Middle Name:
NORMA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHD, M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FENICHEL
Provider Other First Name:
MONA SOPHIE
Provider Other Middle Name:
NORMA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619296167
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
157 CHESTNUT CROSSING DR
Provider Second Line Business Mailing Address:
#L
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-2646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-533-7122
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 BRENNEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-3906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-454-2202
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2010

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: 235Z00000X , with the licence number:  01-0001240 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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