Provider Demographics
NPI:1790780443
Name:KLEINHENZ, LINDA M (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:KLEINHENZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 ALL ANGELS HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3322
Mailing Address - Country:US
Mailing Address - Phone:845-297-1812
Mailing Address - Fax:
Practice Address - Street 1:153 ALL ANGELS HILL RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3322
Practice Address - Country:US
Practice Address - Phone:845-297-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-18
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003884-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400004431Medicare PIN