Provider Demographics
NPI:1962423723
Name:KLEIN, MICHAEL STEVEN (DPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEVEN
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 OYSTER BAY ROAD
Mailing Address - Street 2:STE D
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732
Mailing Address - Country:US
Mailing Address - Phone:516-624-2101
Mailing Address - Fax:516-624-2102
Practice Address - Street 1:898 OYSTER BAY ROAD
Practice Address - Street 2:STE D
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732
Practice Address - Country:US
Practice Address - Phone:516-624-2101
Practice Address - Fax:516-624-2102
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004403213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01674799Medicaid
NYP46951Medicare PIN
NY480026606Medicare PIN
NY01674799Medicaid
NY4747800001Medicare NSC