Provider Demographics
NPI:1912067307
Name:STEVEN KLEIN DO PC
Entity Type:Organization
Organization Name:STEVEN KLEIN DO PC
Other - Org Name:STEVEN KLEIN DO MPH
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO MPH
Authorized Official - Phone:856-456-3888
Mailing Address - Street 1:104 S BROADWAY
Mailing Address - Street 2:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB49659207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3328808Medicaid
C33715Medicare UPIN
NJ3328808Medicaid