Provider Demographics
NPI:1073928370
Name:KLEIN, KELLEY-ANNE CYZESKI (MD)
Entity Type:Individual
Prefix:
First Name:KELLEY-ANNE
Middle Name:CYZESKI
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-723-7723
Mailing Address - Fax:585-723-7301
Practice Address - Street 1:1565 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4122
Practice Address - Country:US
Practice Address - Phone:585-723-7723
Practice Address - Fax:585-723-7301
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296688207QA0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine