Provider Demographics
NPI:1215037981
Name:KLINE, ROXANA G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:G
Last Name:KLINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:332 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1430
Mailing Address - Country:US
Mailing Address - Phone:201-488-6445
Mailing Address - Fax:201-488-6441
Practice Address - Street 1:332 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1430
Practice Address - Country:US
Practice Address - Phone:201-488-6445
Practice Address - Fax:201-488-6441
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06748600208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG79679Medicare UPIN
NJ017272T32Medicare PIN