Basic Information
| Provider Information | |||||||||
| NPI: | 1811181878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLEIN-PATEL | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | ELLEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 HIGBEE DR STE D206 | ||||||||
| Address2: | |||||||||
| City: | BETHEL PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151024200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128547140 | ||||||||
| FaxNumber: | 4128547142 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 HIGBEE DR STE D206 | ||||||||
| Address2: | |||||||||
| City: | BETHEL PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151024200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128547140 | ||||||||
| FaxNumber: | 4128547142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2007 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD435991 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VG0400X | MD435991 | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 102505006 | 05 | PA | MEDICAID |