Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 25MA02059200 | NJ |
NPI | 1104808872 |
---|---|
Provider Name | Dr. George L Kline JR. |
First Address | Chester, NJ 07930-2481 |
Second Address | Chester, NJ 07930-2481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2665808 | (05) | NJ |
E38671 | (02) | NJ |