MEDICARE: ZENITA KLASS

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	164W00000X	Licensed Practical Nurse	292181	NY

General Provider Information

NPI Number	:	1598048480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZENITA KLASS

Provider Business Mailing Address
First Line	:	3 HIGHLAND AVE
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 HIGHLAND AVE
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1013
Country	:	US
Telephone Number	:	631-896-3378
Fax Number	:

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

Provider Enumeration Date	:	09/27/2011
Last Update Date	:	09/27/2011

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Directions to “ ZENITA KLASS ” Practice Location

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