Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 027004 | NY |
NPI | 1073701892 |
---|---|
Provider Name | Dr. Michael Bruce Klein |
First Address | New York City, NY 10036 |
Second Address | New York City, NY 10036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2007 |
Last Update Date | 05/10/2007 |