Healthcare Provider Details

I. General information

NPI: 1902114788
Provider Name (Legal Business Name): ROBERT BRUCE KLEIMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 OVERHILL RD
BALA CYNWYD PA
19004-2228
US

IV. Provider business mailing address

129 OVERHILL RD
BALA CYNWYD PA
19004-2228
US

V. Phone/Fax

Practice location:
  • Phone: 610-667-4706
  • Fax: 610-667-5892
Mailing address:
  • Phone: 610-667-4706
  • Fax: 610-667-5892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD032956E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: