Provider Demographics
NPI:1609814714
Name:KLEIN, EDWARD F (DO)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:F
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2 COATES DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6758
Mailing Address - Country:US
Mailing Address - Phone:845-651-1400
Mailing Address - Fax:845-651-1512
Practice Address - Street 1:2904 ROUTE 6
Practice Address - Street 2:SUITE 1
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-3810
Practice Address - Country:US
Practice Address - Phone:845-355-4611
Practice Address - Fax:845-355-2776
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY216568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H33719Medicare UPIN