Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 3099-1 | NY |
NPI | 1033126776 |
---|---|
Provider Name | Dr. Richard Douglas Kleinman |
First Address | New City, NY 10956-4132 |
Second Address | New City, NY 10956-4132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T50986 | (02) | NY |