Provider Demographics
NPI:1659657971
Name:KLESH, MARTIN J (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:J
Last Name:KLESH
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:PO BOX 10439
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08650-4039
Mailing Address - Country:US
Mailing Address - Phone:609-581-5303
Mailing Address - Fax:609-631-6839
Practice Address - Street 1:610 W GERMANTOWN PIKE STE 150
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1062
Practice Address - Country:US
Practice Address - Phone:215-932-5878
Practice Address - Fax:609-631-6839
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2023-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NR12445100367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered