Healthcare Provider Details

I. General information

NPI: 1568457752
Provider Name (Legal Business Name): DAVID MAXWELL KLEINMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CRITTENDEN AVE
ROCHESTER NY
14642
US

IV. Provider business mailing address

601 ELMWOOD AVENUE BOX 659
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 585-273-3937
  • Fax: 585-276-0292
Mailing address:
  • Phone: 585-273-3937
  • Fax: 585-276-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number226139
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number226139
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: