MEDICARE: STEVEN SCHLOSS GARY KLEIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	036361	NY
2	122300000X	Dentist	035905	NY

General Provider Information

NPI Number	:	1063624344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN SCHLOSS GARY KLEIN DDS

Provider Business Mailing Address
First Line	:	36 W 44TH ST
Second Line	:	SUITE 402
City	:	NEW YORK
State	:	NY
Zip	:	10036-8102
Country	:	US
Telephone Number	:	212-873-1234
Fax Number	:	917-979-4542

Provider Business Practice Location Address
First Line	:	36 W 44TH ST
Second Line	:	SUITE 402
City	:	NEW YORK
State	:	NY
Zip	:	10036-8102
Country	:	US
Telephone Number	:	212-873-1234
Fax Number	:	917-979-4542

Authorized Official
Title or Position	:	CONTACT
Name	:	JESSICA BOYLE
Credential	:
Telephone Number	:	212-873-1234

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	06/07/2016

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