Provider Demographics
NPI:1932200755
Name:KLEIN, JENNIFER H (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:H
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:ZINDERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9613 HARFORD RD STE 134
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2150
Mailing Address - Country:US
Mailing Address - Phone:443-461-6767
Mailing Address - Fax:443-259-3711
Practice Address - Street 1:6350 STEVENS FOREST RD STE 105
Practice Address - Street 2:SUITE 134
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3255
Practice Address - Country:US
Practice Address - Phone:443-259-3770
Practice Address - Fax:443-259-3711
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055637208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H34928Medicare UPIN