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General NPI Number Information
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NPI Number | 1790787653
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Entity Type | Individual
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Provider Name | DAVID MARC KLEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 09/03/2012
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Provider Practice Location Address
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Address Line | 4406 12TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11219-1094
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Country | US
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Telephone | 718-438-4400
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Fax | 718-438-4404
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Provider Business Mailing Address
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Address Line | 1248 WATERVIEW ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1743
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Country | US
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Telephone | 718-868-4303
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 226188
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License Number State | NY
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