Provider Demographics
NPI:1154410926
Name:KLEIN, VICTOR R (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:R
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:825 NORTHERN BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-472-5700
Mailing Address - Fax:516-472-5703
Practice Address - Street 1:825 NORTHERN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5323
Practice Address - Country:US
Practice Address - Phone:516-472-5700
Practice Address - Fax:516-472-5703
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY146935207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0200166OtherGHI
NY062GT1OtherEMPIRE BCBS
AP553OtherOXFORD
0116243OtherAETNA
AP553OtherOXFORD
0116243OtherAETNA
B24008Medicare UPIN