Provider Demographics
NPI:1790787653
Name:KLEIN, DAVID MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARC
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 WATERVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1743
Mailing Address - Country:US
Mailing Address - Phone:718-868-4303
Mailing Address - Fax:
Practice Address - Street 1:4406 12TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1094
Practice Address - Country:US
Practice Address - Phone:718-438-4400
Practice Address - Fax:718-438-4404
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226188208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics