Healthcare Provider Details

I. General information

NPI: 1073985842
Provider Name (Legal Business Name): S. KLEIN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21333 39TH AVE STE 240
BAYSIDE NY
11361-2091
US

IV. Provider business mailing address

21333 39TH AVE SUITE 240
BAYSIDE NY
11361-2091
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 TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN KLEIN
Title or Position: OWNER
Credential: M.D.
Phone: 917-880-8079