Provider Demographics
NPI:1245278886
Name:ADLER-KLEIN, DEBRA (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:ADLER-KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 SAND PIT RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4005
Mailing Address - Country:US
Mailing Address - Phone:203-749-5700
Mailing Address - Fax:203-830-8088
Practice Address - Street 1:79 SAND PIT RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4005
Practice Address - Country:US
Practice Address - Phone:203-749-5700
Practice Address - Fax:203-383-0808
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029017207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004002705Medicaid
CT110008479Medicare ID - Type Unspecified
E45514Medicare UPIN