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NPI Code Detail

MEDICARE: ALYSSA ANN KLEIN MPT

MEDICARE: ALYSSA ANN KLEIN MPT
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
12251X0800XOrthopedic Physical Therapist17125MA
2225100000XPhysical Therapist023976-1NY

General Provider Information

NPI Number : 1528285822
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA ANN KLEIN MPT
Provider Business Mailing Address
First Line : 1010 ROUTE 112
Second Line : SUITE 200
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-3387
Country : US
Telephone Number : 631-476-4880
Fax Number :
Provider Business Practice Location Address
First Line : 1010 ROUTE 112
Second Line : SUITE 200
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-3387
Country : US
Telephone Number : 631-476-4880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 10/13/2011

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Directions to “ ALYSSA ANN KLEIN MPT” Practice Location

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