Provider Demographics
NPI:1316263833
Name:KLEIN, RACHEL RAMIREZ (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:RAMIREZ
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 COLUMBUS AVENUE
Mailing Address - Street 2:CREDENTIALING SPECIALIST
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1233
Mailing Address - Country:US
Mailing Address - Phone:203-503-3174
Mailing Address - Fax:203-503-6515
Practice Address - Street 1:400 COLUMBUS AVE
Practice Address - Street 2:APC
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519
Practice Address - Country:US
Practice Address - Phone:203-503-3075
Practice Address - Fax:203-503-3296
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT515842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008052780Medicaid