Provider Demographics
NPI:1760477566
Name:KLEEMAN, HARRIS JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRIS
Middle Name:JAY
Last Name:KLEEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1170
Mailing Address - Country:US
Mailing Address - Phone:718-375-6969
Mailing Address - Fax:
Practice Address - Street 1:1660 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1170
Practice Address - Country:US
Practice Address - Phone:718-375-6969
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146566207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
52A041Medicare ID - Type Unspecified
B80427Medicare UPIN