MEDICARE: KLOPMAN LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1457109522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLOPMAN LLC

Provider Business Mailing Address
First Line	:	1024 E 27TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3740
Country	:	US
Telephone Number	:	973-558-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	1024 E 27TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3740
Country	:	US
Telephone Number	:	973-558-0966
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DERK JAN KLOMPSMA
Credential	:
Telephone Number	:	973-558-0966

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	05/13/2024

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Directions to “KLOPMAN LLC ” Practice Location

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