MEDICARE: MR. JOHN M KLEFEKER BC-HIS

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	237700000X	Hearing Instrument Specialist	127	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518094762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN M KLEFEKER BC-HIS

Provider Business Mailing Address
First Line	:	534 MAIN ST
Second Line	:	SUITE2
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-1872
Country	:	US
Telephone Number	:	781-337-1144
Fax Number	:	781-337-6565

Provider Business Practice Location Address
First Line	:	534 MAIN ST
Second Line	:	SUITE2
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-1872
Country	:	US
Telephone Number	:	781-337-1144
Fax Number	:	781-337-6565

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/09/2007

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