Individual
MARK JACOB KLEINMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3915 HYLAN BLVD, STATEN ISLAND, NY 10308-3425
(718) 948-7800
(718) 948-1733
Mailing address
144 NEHRING AVE, STATEN ISLAND, NY 10314-6120
(917) 595-7520
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010039
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02400397
—
NY
Enumeration date
07/25/2006
Last updated
07/08/2007
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