Provider Demographics
NPI:1912952300
Name:BARRY ALAN KLEIN
Entity Type:Organization
Organization Name:BARRY ALAN KLEIN
Other - Org Name:BLACKWOOD-CLEMENTON FOOT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-783-3366
Mailing Address - Street 1:1130 BLACKWOOD CLEMENTON RD
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6965
Mailing Address - Country:US
Mailing Address - Phone:856-783-3366
Mailing Address - Fax:856-782-1648
Practice Address - Street 1:1130 BLACKWOOD CLEMENTON RD
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-6965
Practice Address - Country:US
Practice Address - Phone:856-783-3366
Practice Address - Fax:856-782-1648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3091406Medicaid
NJ3091406Medicaid
NJ0653540001Medicare NSC