Provider Demographics
NPI:1477710796
Name:KLEINERMAN, REBECCA (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:KLEINERMAN
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 1:132 E 76TH ST
Mailing Address - Street 2:OFC 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2850
Mailing Address - Country:US
Mailing Address - Phone:212-570-5777
Mailing Address - Fax:866-271-1841
Practice Address - Street 1:132 E 76TH ST
Practice Address - Street 2:OFC 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2850
Practice Address - Country:US
Practice Address - Phone:212-570-5777
Practice Address - Fax:866-271-1841
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247435207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400036366Medicare PIN