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General NPI Number Information
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NPI Number | 1174670889
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Entity Type | Organization
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Legal Business Name | KLINGER M.D. AND MISRA M.D. PTR
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 880 N BROADWAY
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City | MASSAPEQUA
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State | NY
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Zip | 11758-2351
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Country | US
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Telephone | 516-541-0300
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Fax | 516-541-6390
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Provider Business Mailing Address
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Address Line | 880 N BROADWAY
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City | MASSAPEQUA
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State | NY
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Zip | 11758-2351
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Country | US
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Telephone | 516-541-0300
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Fax | 516-541-6390
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD F KLINGER
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Credential | M.D.
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Telephone | 516-541-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 189741
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 227038
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 160815
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License Number State | NY
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