Provider Demographics
NPI:1497000145
Name:KLEK, STANISLAW PIOTR (MD)
Entity Type:Individual
Prefix:DR
First Name:STANISLAW
Middle Name:PIOTR
Last Name:KLEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MINEOLA BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4007
Practice Address - Country:US
Practice Address - Phone:516-663-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274623207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism