Healthcare Provider Details

I. General information

NPI: 1700958147
Provider Name (Legal Business Name): JASON H KLEIN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 E 74TH ST STE 3
NEW YORK NY
10021-3235
US

IV. Provider business mailing address

159 E 74TH ST STE 3
NEW YORK NY
10021-3235
US

V. Phone/Fax

Practice location:
  • Phone: 212-838-8023
  • Fax: 212-838-8027
Mailing address:
  • Phone: 917-774-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022325
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: