Healthcare Provider Details

I. General information

NPI: 1144326133
Provider Name (Legal Business Name): ANATOLE KENNETH KLEINER M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/05/2023
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 RED CREEK DR STE 240
ROCHESTER NY
14623-4281
US

IV. Provider business mailing address

400 RED CREEK DR STE 240
ROCHESTER NY
14623-4281
US

V. Phone/Fax

Practice location:
  • Phone: 585-486-0901
  • Fax: 585-340-5399
Mailing address:
  • Phone: 585-486-0901
  • Fax: 585-340-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number234607
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number234607
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number234607
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: