Provider Demographics
NPI:1831187319
Name:KLEINSTEIN, JUDY A (MD)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:A
Last Name:KLEINSTEIN
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 1:3800 QUAKERBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1010
Mailing Address - Country:US
Mailing Address - Phone:609-890-6100
Mailing Address - Fax:609-586-0399
Practice Address - Street 1:1 LONG WHARF DR STE 500
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5593
Practice Address - Country:US
Practice Address - Phone:203-781-4444
Practice Address - Fax:203-789-8341
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA75721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I21527Medicare UPIN
696800Medicare ID - Type Unspecified