Provider Demographics
NPI:1821423419
Name:KLEYNBERG, STELLA (MS)
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:
Last Name:KLEYNBERG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3448 NE 210TH TER
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3580
Mailing Address - Country:US
Mailing Address - Phone:646-573-1700
Mailing Address - Fax:
Practice Address - Street 1:3448 NE 210TH TER
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3580
Practice Address - Country:US
Practice Address - Phone:646-573-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY844941174H00000X, 222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No174H00000XOther Service ProvidersHealth Educator