Provider Demographics
NPI:1740589258
Name:KLEYDMAN, YEKATERINA (DO)
Entity Type:Individual
Prefix:DR
First Name:YEKATERINA
Middle Name:
Last Name:KLEYDMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 OCEAN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3202
Mailing Address - Country:US
Mailing Address - Phone:718-676-6900
Mailing Address - Fax:718-676-6901
Practice Address - Street 1:2960 OCEAN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3202
Practice Address - Country:US
Practice Address - Phone:718-676-6900
Practice Address - Fax:718-676-6901
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254386207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery