Provider Demographics
NPI:1871813709
Name:KLEIN, RACHEL S (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:S
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 1:622 STOKES RD
Mailing Address - Street 2:STE A
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:622 STOKES RD
Practice Address - Street 2:STE A
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2913
Practice Address - Country:US
Practice Address - Phone:609-953-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197215207R00000X
NJ25MA09715900207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine