Provider Demographics
NPI:1104271766
Name:KLEINERT, ROY
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:KLEINERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ROUTE 34
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3473
Mailing Address - Country:US
Mailing Address - Phone:732-566-1112
Mailing Address - Fax:732-566-1044
Practice Address - Street 1:1000 ROUTE 34
Practice Address - Street 2:SUITE 204
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3473
Practice Address - Country:US
Practice Address - Phone:732-566-1112
Practice Address - Fax:732-566-1044
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0204800376J00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker