Provider Demographics
NPI:1801293659
Name:KLEEN, CHELSEA (OD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:KLEEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:485 ROUTE 1 S
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3009
Mailing Address - Country:US
Mailing Address - Phone:732-750-0400
Mailing Address - Fax:732-602-0749
Practice Address - Street 1:485 ROUTE 1 S
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3009
Practice Address - Country:US
Practice Address - Phone:732-750-0400
Practice Address - Fax:732-602-0749
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00124200152W00000X
NJ27OA00656800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist