Provider Demographics
NPI:1063710648
Name:KLEIN, DENA MELISSA (LPN)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:MELISSA
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ARCADIA DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6904
Mailing Address - Country:US
Mailing Address - Phone:631-667-1430
Mailing Address - Fax:631-274-5683
Practice Address - Street 1:3 ARCADIA DR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6904
Practice Address - Country:US
Practice Address - Phone:631-667-1430
Practice Address - Fax:631-274-5683
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280883164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse