Provider Demographics
NPI:1639515588
Name:PAUL G KLEIN DPM PA
Entity Type:Organization
Organization Name:PAUL G KLEIN DPM PA
Other - Org Name:NORTH JERSEY PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCNAMEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-953-4308
Mailing Address - Street 1:401 HAMBURG TPKE STE 110
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2139
Mailing Address - Country:US
Mailing Address - Phone:973-595-1555
Mailing Address - Fax:973-595-6849
Practice Address - Street 1:401 HAMBURG TPKE STE 110
Practice Address - Street 2:401 HAMBURG TURNPIKE
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2139
Practice Address - Country:US
Practice Address - Phone:973-595-1555
Practice Address - Fax:973-595-6849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01318213E00000X, 213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ444395Medicare PIN
NJT45017Medicare UPIN