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General NPI Number Information
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NPI Number | 1437578655
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Entity Type | Individual
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Provider Name | JORDAN KLEBANOFF
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 3855 W CHESTER PIKE STE 340
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2304
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Country | US
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Telephone | 484-227-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 3803 W CHESTER PIKE STE 160
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2336
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Country | US
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Telephone | 484-337-1632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD046048
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD470445
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License Number State | PA
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