Healthcare Provider Details

I. General information

NPI: 1720186612
Provider Name (Legal Business Name): DR MICHAEL KLEIN & DR GIDEON TARRASH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 OYSTER BAY RD D
EAST NORWICH NY
11732-1051
US

IV. Provider business mailing address

898 OYSTER BAY RD D
EAST NORWICH NY
11732-1051
US

V. Phone/Fax

Practice location:
  • Phone: 516-624-2101
  • Fax: 516-624-2102
Mailing address:
  • Phone: 516-624-2101
  • Fax: 516-624-2102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNY

VIII. Authorized Official

Name: MRS. JOSETTE ZAPPA
Title or Position: OFFICE MANAGER
Credential:
Phone: 516-624-2101