Provider Demographics
NPI:1356662399
Name:KLEIN, MICHELLE (DC, CNS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DC, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E SHORE RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 E SHORE RD
Practice Address - Street 2:SUITE 305
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2410
Practice Address - Country:US
Practice Address - Phone:516-466-1045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011189111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition