MEDICARE: NORTHERN WESTCHESTER INTERNAL MEDICINE

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	207R00000X	Internal Medicine Physician	225325	NY
2	207RI0200X	Infectious Disease Physician	101328	NY
3	207R00000X	Internal Medicine Physician	208923	NY

General Provider Information

NPI Number	:	1386738664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN WESTCHESTER INTERNAL MEDICINE

Provider Business Mailing Address
First Line	:	1872 COMMERCE ST
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598
Country	:	US
Telephone Number	:	914-962-3303
Fax Number	:	914-962-4271

Provider Business Practice Location Address
First Line	:	1872 COMMERCE ST
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4430
Country	:	US
Telephone Number	:	914-962-3303
Fax Number	:	914-962-4271

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD S KLEIN
Credential	:	MD
Telephone Number	:	914-962-3303

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	04/22/2013

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