Provider Demographics
NPI:1689769325
Name:KLEIN, STEVEN E (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1790
Mailing Address - Country:US
Mailing Address - Phone:631-261-4445
Mailing Address - Fax:631-261-3710
Practice Address - Street 1:325 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1790
Practice Address - Country:US
Practice Address - Phone:631-261-4445
Practice Address - Fax:631-261-3710
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY162359-30OtherHEALTH FIRST
NY0012303OtherGHI
NY2C7645OtherHEALTHNET
NY162359-30OtherHEALTH FIRST
A60769Medicare UPIN
NY0012303OtherGHI
1172OtherVYTRA
NY162359-30OtherHEALTH FIRST