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NPI Code Detail

MEDICARE: MYRON I KLEINER M.D.

MEDICARE: MYRON I KLEINER M.D.
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
1174400000XSpecialist142909NY

Other Identifiers

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

General Provider Information

NPI Number : 1760468854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRON I KLEINER M.D.
Provider Business Mailing Address
First Line : 180 E MAIN ST
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-8427
Country : US
Telephone Number : 631-665-4466
Fax Number : 631-665-2716
Provider Business Practice Location Address
First Line : 180 E MAIN ST
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-8427
Country : US
Telephone Number : 631-665-4466
Fax Number : 631-665-2716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 07/30/2007

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Directions to “ MYRON I KLEINER M.D.” Practice Location

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