Provider Demographics
NPI:1598064321
Name:KLIGMAN, BRAD EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:EVAN
Last Name:KLIGMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:133 PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2331
Mailing Address - Country:US
Mailing Address - Phone:516-627-0033
Mailing Address - Fax:516-627-7354
Practice Address - Street 1:133 PLANDOME RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2331
Practice Address - Country:US
Practice Address - Phone:516-627-0033
Practice Address - Fax:516-627-7354
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY266649207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist