Provider Demographics
NPI:1225813322
Name:KLEIN, JULIA IRENE (RDN)
Entity Type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:IRENE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WOODRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2203
Mailing Address - Country:US
Mailing Address - Phone:518-925-8738
Mailing Address - Fax:
Practice Address - Street 1:18 WOODRIDGE RD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-2203
Practice Address - Country:US
Practice Address - Phone:518-925-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
NY011603133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered