Provider Demographics
NPI:1447331608
Name:KLEIN, CHARNA (MD)
Entity type:Individual
Prefix:
First Name:CHARNA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ADVANCED ONCOLOGY OF MONTEFIORE
Mailing Address - Street 2:1625 POPLAR STREET
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2103
Mailing Address - Country:US
Mailing Address - Phone:718-405-8010
Mailing Address - Fax:718-405-8010
Practice Address - Street 1:75 GUNHILL ROAD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-655-3932
Practice Address - Fax:718-231-7401
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2062681207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02211892Medicaid
NY02211892Medicaid
H55832Medicare UPIN