Provider Demographics
NPI:1417222555
Name:KLEIN, ROBIN C (RD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:C
Last Name:KLEIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:C
Other - Last Name:RUDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:212 IDRIS RD APT Z1
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1659
Mailing Address - Country:US
Mailing Address - Phone:610-220-0829
Mailing Address - Fax:
Practice Address - Street 1:212 IDRIS RD APT Z1
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1659
Practice Address - Country:US
Practice Address - Phone:610-220-0829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN0000467133V00000X
PADN005072133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103076749Medicaid
PA453846Medicare PIN