Provider Demographics
NPI:1780930776
Name:KLEJNA, PETER BLAIR
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:BLAIR
Last Name:KLEJNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01096-9726
Mailing Address - Country:US
Mailing Address - Phone:413-268-3257
Mailing Address - Fax:
Practice Address - Street 1:58 SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MA
Practice Address - Zip Code:01096-9726
Practice Address - Country:US
Practice Address - Phone:413-268-3257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program