Healthcare Provider Details

I. General information

NPI: 1932200755
Provider Name (Legal Business Name): JENNIFER H KLEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ZINDERMAN MD

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/26/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 STEVENS FOREST RD STE 105 SUITE 134
COLUMBIA MD
21046-3255
US

IV. Provider business mailing address

9613 HARFORD RD STE 134
PARKVILLE MD
21234-2150
US

V. Phone/Fax

Practice location:
  • Phone: 443-259-3770
  • Fax: 443-259-3711
Mailing address:
  • Phone: 443-461-6767
  • Fax: 443-259-3711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0055637
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: