1659359578 NPI number — WILLIAM M KLEIN MD

Table of content: WILLIAM M KLEIN MD (NPI 1659359578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659359578 NPI number — WILLIAM M KLEIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEIN
Provider First Name:
WILLIAM
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1659359578
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 NORTHERN BLVD
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
GREAT NECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11021-5312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-627-4433
Provider Business Mailing Address Fax Number:
516-627-0552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 NORTHERN BLVD
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
GREAT NECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11021-5312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-627-4433
Provider Business Practice Location Address Fax Number:
516-627-0552
Provider Enumeration Date:
01/03/2006

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: 207R00000X , with the licence number:  205508 , 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: 136958 . This is a "VYTRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3651757 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: A28929 . This is a "1199" identifier . This identifiers is of the category "OTHER".
  • Identifier: WK07R53510 . This is a "BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3695174 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205508 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4C4799 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2594094 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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