1245306455 NPI number — ROBERT M KLEIN MD

Table of content: (NPI 1245306455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245306455 NPI number — ROBERT M KLEIN MD

Organization/Personal Information

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

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1245306455
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1005 CLIFTON AVE
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07013-3520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-773-7400
Provider Business Mailing Address Fax Number:
973-779-5224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 CLIFTON AVE
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07013-3520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-773-7400
Provider Business Practice Location Address Fax Number:
973-779-5224
Provider Enumeration Date:
11/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KLEIN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
HEAD OF ORGANIZATION
Authorized Official Telephone Number:
973-773-7400

Provider Taxonomy Codes

  • Taxonomy code: 207KA0200X , with the licence number:  MA33401 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207KA0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 061685 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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