Healthcare Provider Details

I. General information

NPI: 1164595534
Provider Name (Legal Business Name): HARVEY KLEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 05/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 AVENUE I
BROOKLYN NY
11230-2653
US

IV. Provider business mailing address

80-03 211TH STREET
HOLLIS HILLS NY
11427
US

V. Phone/Fax

Practice location:
  • Phone: 718-253-1414
  • Fax:
Mailing address:
  • Phone: 718-464-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number147827
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA08297300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: