Provider Demographics
NPI:1588682231
Name:KLEIN-CHAST, MARCIA R (DO)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:R
Last Name:KLEIN-CHAST
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:404 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 306 PENNS SQUARE
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1897
Mailing Address - Country:US
Mailing Address - Phone:215-269-3330
Mailing Address - Fax:215-269-3355
Practice Address - Street 1:404 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 306 PENNS SQUARE
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1897
Practice Address - Country:US
Practice Address - Phone:215-269-3330
Practice Address - Fax:215-269-3355
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS009017L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA029020OtherKEYSONE HEALTH PLAN EAST
PAKL29020OtherBLUE SHIELD
PAP1092570OtherOXFORD
PA2087258OtherUSHC
PA0017143680002Medicaid
PA233044033OtherTAX ID
PA0171436802OtherAMERICHOICE
PA1103365OtherKEYSTONE MERCY