Provider Demographics
NPI:1306924519
Name:KLEIN, DANIEL P (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 E 79TH ST
Mailing Address - Street 2:1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0866
Mailing Address - Country:US
Mailing Address - Phone:212-737-2000
Mailing Address - Fax:212-737-2936
Practice Address - Street 1:229 E 79TH ST
Practice Address - Street 2:1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0866
Practice Address - Country:US
Practice Address - Phone:212-737-2000
Practice Address - Fax:212-737-2936
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172225207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01112789Medicaid
NY01112789Medicaid
NYD92181Medicare UPIN