MEDICARE: GOLDIE KLEIN

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1538615950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GOLDIE KLEIN

Provider Business Mailing Address
First Line	:	1242 50TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3540
Country	:	US
Telephone Number	:	718-854-9406
Fax Number	:	718-854-1885

Provider Business Practice Location Address
First Line	:	1242 50TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3540
Country	:	US
Telephone Number	:	718-854-9406
Fax Number	:	718-854-1885

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

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	08/26/2016

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Directions to “ GOLDIE KLEIN ” Practice Location

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