Healthcare Provider Details

I. General information

NPI: 1346485091
Provider Name (Legal Business Name): DANIEL LAWRENCE KLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 STEWART AVE SUITE 400
GARDEN CITY NY
11530-4822
US

IV. Provider business mailing address

990 STEWART AVE SUITE 400
GARDEN CITY NY
11530-4822
US

V. Phone/Fax

Practice location:
  • Phone: 516-222-2022
  • Fax: 516-222-8475
Mailing address:
  • Phone: 516-222-2022
  • Fax: 516-222-8475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number257430
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: