Provider Demographics
NPI:1841395407
Name:KLEIN, DANIELA GUTTA
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:GUTTA
Last Name:KLEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:SONDHEIMER
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, MS, LMHC, NCC
Mailing Address - Street 1:34 BACON RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1503
Mailing Address - Country:US
Mailing Address - Phone:516-333-4166
Mailing Address - Fax:
Practice Address - Street 1:34 BACON RD
Practice Address - Street 2:SUITE #260B
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-1503
Practice Address - Country:US
Practice Address - Phone:516-367-6069
Practice Address - Fax:516-876-9607
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000985-01101YM0800X
NY002673-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A523322OtherOXFORD HEALTH PLANS
A523322OtherOXFORD HEALTH PLANS