=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649554692
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANDREW C. KLEIN PHYSICAL THERAPY, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2011
-----------------------------------------------------
Last Update Date | 10/07/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 838 PELHAMDALE AVE
-----------------------------------------------------
City | NEW ROCHELLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10801-1032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-576-5827
-----------------------------------------------------
Fax | 914-576-5878
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 838 PELHAMDALE AVE
-----------------------------------------------------
City | NEW ROCHELLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10801-1032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-576-5827
-----------------------------------------------------
Fax | 914-576-5878
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MARCY LIPPMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-576-5827
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 003778
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------