Provider Demographics
NPI:1710170865
Name:KLENN, PHILIP J (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:KLENN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2701 DEKALB PIKE
Mailing Address - Street 2:PATH LAB
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1820
Mailing Address - Country:US
Mailing Address - Phone:570-366-4606
Mailing Address - Fax:570-366-5193
Practice Address - Street 1:2701 DEKALB PIKE
Practice Address - Street 2:PATH LAB
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1820
Practice Address - Country:US
Practice Address - Phone:570-366-4606
Practice Address - Fax:570-366-5193
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2017-04-13
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Provider Licenses
StateLicense IDTaxonomies
PAMD046616L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF92971Medicare UPIN