MEDICARE: MRS. SUIYIN KLEINBERG MD

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	174400000X	Specialist	208324	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J22990	OTHER	MA	BLUE CROSS PROVIDER ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073514683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUIYIN KLEINBERG MD

Provider Business Mailing Address
First Line	:	83 SOUTH ST
Second Line	:	SUITE 5
City	:	WARE
State	:	MA
Zip	:	01082-1660
Country	:	US
Telephone Number	:	413-967-0202
Fax Number	:	413-967-4202

Provider Business Practice Location Address
First Line	:	83 SOUTH ST
Second Line	:	SUITE 5
City	:	WARE
State	:	MA
Zip	:	01082-1660
Country	:	US
Telephone Number	:	413-967-0202
Fax Number	:	413-967-4202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	07/08/2007

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