Healthcare Provider Details

I. General information

NPI: 1245625730
Provider Name (Legal Business Name): DR. BRITANY KLENOFSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST FL 7
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

5 EAST 98TH ST BOX 1139
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-7076
  • Fax: 212-241-2542
Mailing address:
  • Phone: 212-241-7076
  • Fax: 212-241-2542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number297101-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: