1871008383 NPI number — MEGAN ALI KLEIN PA

Table of content: MEGAN ALI KLEIN PA (NPI 1871008383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871008383 NPI number — MEGAN ALI KLEIN PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEIN
Provider First Name:
MEGAN
Provider Middle Name:
ALI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

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:
1871008383
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11806 RIDGEMONT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUTHERVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-1617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-916-0581
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7601 OSLER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-7700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-337-7900
Provider Business Practice Location Address Fax Number:
410-769-8591
Provider Enumeration Date:
12/06/2017

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: 363A00000X , with the licence number:  C0006683 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: C06683 . This is a "MBOP LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com