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General NPI Number Information
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NPI Number | 1699961789
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Entity Type | Organization
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Legal Business Name | KLETT OCULOPLASTIC SURGERY, PC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 46 PRINCE ST SUITE 404
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City | NEW HAVEN
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State | CT
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Zip | 06519-1600
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Country | US
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Telephone | 203-785-1766
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Fax | 203-772-3259
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Provider Business Mailing Address
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Address Line | 46 PRINCE ST SUITE 404
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City | NEW HAVEN
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State | CT
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Zip | 06519-1600
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Country | US
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Telephone | 203-785-1766
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Fax | 203-772-3259
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZACHARY GEORGE KLETT
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Credential | M.D.
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Telephone | 203-785-1766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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