Provider Demographics
NPI:1518328640
Name:REBECCA KLEINERMAN, M.D., P.L.L.C.
Entity Type:Organization
Organization Name:REBECCA KLEINERMAN, M.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-208-5124
Mailing Address - Street 1:132 E 76TH ST OFC 2E
Mailing Address - Street 2:
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:
Practice Address - Street 1:132 E 76TH ST OFC 2E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2850
Practice Address - Country:US
Practice Address - Phone:917-208-5124
Practice Address - Fax:866-271-1841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247435207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty