Healthcare Provider Details

I. General information

NPI: 1275773459
Provider Name (Legal Business Name): BRIAN KLEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 SHEPHERD LN
ROSLYN HEIGHTS NY
11577-2507
US

IV. Provider business mailing address

52 SHEPHERD LN
ROSLYN HEIGHTS NY
11577-2507
US

V. Phone/Fax

Practice location:
  • Phone: 516-625-5641
  • Fax:
Mailing address:
  • Phone: 516-625-5641
  • Fax: 350-200-5553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number191779
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: