MEDICARE: DR. MITCHELL L KLEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	148277	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	RP171	OTHER	NY	OXFORD
3	17244	OTHER	NY	GHI

General Provider Information

NPI Number	:	1487704573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL L KLEIN MD

Provider Business Mailing Address
First Line	:	65 E MAIN ST
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-1641
Country	:	US
Telephone Number	:	845-942-0283
Fax Number	:	845-942-0389

Provider Business Practice Location Address
First Line	:	65 E MAIN ST
Second Line	:
City	:	STONY POINT
State	:	NY
Zip	:	10980-1641
Country	:	US
Telephone Number	:	845-942-0283
Fax Number	:	845-942-0389

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	01/10/2017

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