Provider Demographics
NPI:1497064489
Name:KLEINMAN, TOM J (LMT)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:J
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 STOCKBRIDGE RD
Mailing Address - Street 2:STE 2
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1773
Mailing Address - Country:US
Mailing Address - Phone:413-717-1612
Mailing Address - Fax:
Practice Address - Street 1:20 STOCKBRIDGE RD
Practice Address - Street 2:STE 2
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1773
Practice Address - Country:US
Practice Address - Phone:413-717-1612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-25
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
MA4257171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor