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General NPI Number Information
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NPI Number | 1346238565
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Entity Type | Individual
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Provider Name | HEIDI KLINGBEIL MD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 180 FORT WASHINGTON AVE SUITE 199
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City | NEW YORK
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State | NY
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Zip | 10032-3735
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Country | US
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Telephone | 212-305-4593
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Fax | 212-342-6852
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Provider Business Mailing Address
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Address Line | 630 WEST 168TH STREET #38
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-305-4593
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Fax | 212-342-6852
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 25MA07919400
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License Number State | NJ
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