Provider Demographics
NPI:1730140914
Name:KLEIN, SAMANTHA (PT)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E 84TH ST
Mailing Address - Street 2:SUITE #1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2047
Mailing Address - Country:US
Mailing Address - Phone:212-517-0020
Mailing Address - Fax:212-517-4526
Practice Address - Street 1:148 E 84TH ST
Practice Address - Street 2:SUITE #1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2047
Practice Address - Country:US
Practice Address - Phone:212-517-0020
Practice Address - Fax:212-517-4526
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0252041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist