MEDICARE: OLEKSANDR KLYMENKO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	84925	CT
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1245920743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLEKSANDR KLYMENKO MD

Provider Business Mailing Address
First Line	:	4222 AVALON VALLEY DR
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-4046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 HOSPITAL AVENUE
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-6099
Country	:	US
Telephone Number	:	203-739-8105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	05/23/2026

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