Klyde, David

Klyde, David is an individual health care provider with primary practice located at 110 S Grove St , East Orange NJ 07018-4102. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Klyde, David can be contacted via phone (973) 677-1027.

Contact Information

Primary practice address
110 S Grove St East Orange NJ 07018-4102
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 25MA06920200 New Jersey

Profile Details

NPI number 1447204946
LBN Legal business name Klyde, David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Mar 11th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447204946 NPPES
New Jersey MEDICAID 0066176

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