Provider Demographics
NPI:1134611619
Name:KLEIN, ROBIN DANIEL (LPN)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:DANIEL
Last Name:KLEIN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E CORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-1111
Mailing Address - Country:US
Mailing Address - Phone:206-816-4116
Mailing Address - Fax:
Practice Address - Street 1:315 E CORTLAND ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-1111
Practice Address - Country:US
Practice Address - Phone:620-816-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320263-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse