Healthcare Provider Details

I. General information

NPI: 1033324496
Provider Name (Legal Business Name): DANIEL KLEINER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 11/23/2020
Certification Date: 11/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 OSBORNE ST
DANBURY CT
06810-6000
US

IV. Provider business mailing address

41 BRONSON MTN
ROXBURY CT
06783-2126
US

V. Phone/Fax

Practice location:
  • Phone: 203-739-7131
  • Fax: 203-739-1554
Mailing address:
  • Phone: 203-981-2981
  • Fax: 203-739-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number52397
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number52397
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: