Individual
MARYELLEN KLAIBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 264-4000
(631) 396-0025
Mailing address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F301203
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F301203
STATE LICENSE
NY
Enumeration date
05/18/2007
Last updated
01/27/2008
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