Provider Demographics
NPI:1568457752
Name:KLEINMAN, DAVID MAXWELL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MAXWELL
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVENUE
Mailing Address - Street 2:BOX 659
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642
Mailing Address - Country:US
Mailing Address - Phone:585-273-3937
Mailing Address - Fax:585-276-0292
Practice Address - Street 1:210 CRITTENDEN AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642
Practice Address - Country:US
Practice Address - Phone:585-273-3937
Practice Address - Fax:585-276-0292
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY226139207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
115954CROtherPREFERRED CARE
P010226139OtherBLUE CHOICE
NY02266517Medicaid
P020226139OtherBLUE SHIELD
NY02266517Medicaid
H16193Medicare UPIN
NYJ400001367Medicare PIN