Provider Demographics
NPI:1245634757
Name:KLEINMAN, KIMBERLY E (PSYD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:E
Last Name:KLEINMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRIDGE ST STE 24
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1552
Mailing Address - Country:US
Mailing Address - Phone:914-721-0125
Mailing Address - Fax:
Practice Address - Street 1:1 BRIDGE ST STE 24
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1552
Practice Address - Country:US
Practice Address - Phone:914-721-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020937103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical