Provider Demographics
NPI:1881605491
Name:KLEINFELD, DAVID IRA (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:IRA
Last Name:KLEINFELD
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 1:1200 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1124
Mailing Address - Country:US
Mailing Address - Phone:732-292-0355
Mailing Address - Fax:732-292-0357
Practice Address - Street 1:1200 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1124
Practice Address - Country:US
Practice Address - Phone:732-292-0355
Practice Address - Fax:732-292-0357
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 42076207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1089609Medicaid
NJKL519180Medicare ID - Type Unspecified
NJ1089609Medicaid