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NPI Code Detail

MEDICARE: JAMIE ILENE KLEIN PA-C

MEDICARE: JAMIE ILENE KLEIN PA-C
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
1363A00000XPhysician Assistant023285NY

General Provider Information

NPI Number : 1124584172
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE ILENE KLEIN PA-C
Provider Business Mailing Address
First Line : 1210 ASTORIA PARK S
Second Line :
City : ASTORIA
State : NY
Zip : 11102-3701
Country : US
Telephone Number : 516-458-0849
Fax Number :
Provider Business Practice Location Address
First Line : 1728 SUNRISE HWY
Second Line :
City : MERRICK
State : NY
Zip : 11566-3745
Country : US
Telephone Number : 516-218-6789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2019
Last Update Date : 03/07/2022

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Directions to “ JAMIE ILENE KLEIN PA-C” Practice Location

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