Provider Demographics
NPI:1871800805
Name:DAVID I KLEINFELD, MD, PA
Entity type:Organization
Organization Name:DAVID I KLEINFELD, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:I
Authorized Official - Last Name:KLEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-292-0355
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 42076207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1089609Medicaid
NJC56646Medicare UPIN
NJ1089609Medicaid