Healthcare Provider Details

I. General information

NPI: 1316158397
Provider Name (Legal Business Name): STEPHEN KLEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213-33 39TH AVE. SUITE 240
BAYSIDE NY
11361
US

IV. Provider business mailing address

333 E. 14TH STREET APT. 7C
NEW YORK NY
10003
US

V. Phone/Fax

Practice location:
  • Phone: 212-673-6083
  • Fax: 718-631-0195
Mailing address:
  • Phone: 212-673-6083
  • Fax: 718-631-0195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number156137-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number156137
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number156137-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number156137-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number156137-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: