Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 35SI00244300 | NJ |
NPI | 1093874224 |
---|---|
Provider Name | Dr. Joel M Kleinman |
First Address | Warren, NJ 07059-5528 |
Second Address | Green Brook, NJ 08812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |