Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001120 | NY |
NPI | 1164644050 |
---|---|
Provider Name | Jeanette S Kleger |
First Address | Vestal, NY 13850 |
Second Address | Vestal, NY 13850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |