Provider Demographics
NPI:1407864663
Name:KLEIN, RICHARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1000 GALLOPING HILL RD STE 305
Mailing Address - Street 2:ASSOCIATED RETINAL CONSULTANTS
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7991
Mailing Address - Country:US
Mailing Address - Phone:908-458-8333
Mailing Address - Fax:908-458-8339
Practice Address - Street 1:3332 ROCHAMBEAU AVE FL 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2836
Practice Address - Country:US
Practice Address - Phone:718-920-5520
Practice Address - Fax:718-881-5439
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY109129207WX0107X
NJ30007207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD19741Medicare UPIN