Provider Demographics
NPI:1972676716
Name:KLEIN, STEVEN (DO MPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DO MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:104 S BROADWAY
Mailing Address - City:GLOUCESTER CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-0389
Mailing Address - Country:US
Mailing Address - Phone:856-456-3888
Mailing Address - Fax:856-456-6444
Practice Address - Street 1:104 S BROADWAY
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-0389
Practice Address - Country:US
Practice Address - Phone:856-456-3888
Practice Address - Fax:856-456-6444
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB49659207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3328805Medicaid
NJ3328805Medicaid
C33715Medicare UPIN