Provider Demographics
NPI:1659359578
Name:KLEIN, WILLIAM M (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1000 NORTHERN BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5312
Mailing Address - Country:US
Mailing Address - Phone:516-627-4433
Mailing Address - Fax:516-627-0552
Practice Address - Street 1:1000 NORTHERN BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5312
Practice Address - Country:US
Practice Address - Phone:516-627-4433
Practice Address - Fax:516-627-0552
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY205508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
136958OtherVYTRA
3651757OtherCIGNA
A28929Other1199
NYWK07R53510OtherBLUE SHIELD
P3695174OtherOXFORD
205508OtherHIP
4C4799OtherHEALTHNET
2594094OtherGHI
G68263Medicare UPIN
6T3691Medicare PIN