Provider Demographics
NPI:1861606568
Name:KLEIN, RISA LYNN (CNM)
Entity type:Individual
Prefix:MS
First Name:RISA
Middle Name:LYNN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1350
Mailing Address - Country:US
Mailing Address - Phone:212-249-4203
Mailing Address - Fax:212-452-2493
Practice Address - Street 1:1490 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1350
Practice Address - Country:US
Practice Address - Phone:212-249-4203
Practice Address - Fax:212-452-2493
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001180-1176B00000X
NJ25ME00041601176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife