Provider Demographics
NPI:1326026683
Name:KLEIN, VICKI (PA)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:ABRAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:73 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7616
Mailing Address - Country:US
Mailing Address - Phone:914-848-8085
Mailing Address - Fax:914-607-4761
Practice Address - Street 1:73 MARKET ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7616
Practice Address - Country:US
Practice Address - Phone:914-848-8085
Practice Address - Fax:914-607-4761
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009888363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009888OtherNYS LICENSE NUMBER