Provider Demographics
NPI:1407898216
Name:KLEEMAN, AUDREY K (MD)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:K
Last Name:KLEEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1057 SECOND STREET PIKE
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954
Practice Address - Country:US
Practice Address - Phone:215-357-5760
Practice Address - Fax:267-364-2005
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD035499E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1222774OtherCIGNA
PA877557OtherUNITED HEALTHCARE
PAPA0047081OtherTRICARE
PA01191856-01OtherAMERICHOICE
PA0011918560010Medicaid
PA01486OtherHEALTH PARTNERS
PA110170082OtherRAILROAD MEDICARE
PA291OtherAETNA
PA405148OtherBLUE SHIELD
PA0054679000OtherKEYSTONE, IBC
PA1022040OtherKEYSTONE MERCY
PA1555092OtherPHCS
PA1591630OtherFIRST HEALTH
PA405148OtherPERSONAL CHOICE
PA8845OtherCLEARCARE
PA1022040OtherKEYSTONE MERCY
PA405148OtherPERSONAL CHOICE