Individual provider Active NPI

Maxine Klein, MD

  • Gynecology Physician
  • Hartford, CT
National Provider Identifier
1366545303
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
029358 Issued in CT
Practice address
100 Retreat Ave
Suite 201
Hartford, CT 06106
Phone
(860) 246-8568
Fax
(860) 728-5076
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 029358 CT Primary

Addresses

Primary practice location

100 Retreat Ave
Suite 201
Hartford, CT 06106

Mailing address

100 Retreat Ave
Suite 201
Hartford, CT 06106
Phone (860) 246-8568

Other identifiers 1

IdentifierTypeStateIssuer
001293589MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
029358CTMDGynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1366545303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 201",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-246-8568",
            "fax_number": "860-728-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 201",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-246-8568",
            "fax_number": "860-728-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "MAXINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CT",
            "license": "029358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001293589",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.