Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 041716 | NY |
NPI | 1063527117 |
---|---|
Provider Name | Dr. Shari B. Klein |
First Address | Bronx, NY 10463-4801 |
Second Address | Bronx, NY 10463-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |