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General NPI Number Information
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NPI Number | 1841336914
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Entity Type | Individual
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Provider Name | BRUCE ROY KLEIN MSW
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3380 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06614
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Country | US
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Telephone | 203-377-6633
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Fax | 203-378-1094
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Provider Business Mailing Address
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Address Line | 150 FOSTER ST
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 203-772-0182
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Fax | 203-378-1094
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000035LCSW
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License Number State | CT
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