MEDICARE: DR. JORDAN KLESMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	170536	NY

General Provider Information

NPI Number	:	1407925779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN KLESMER MD

Provider Business Mailing Address
First Line	:	1 BARSTOW RD STE P10
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-3501
Country	:	US
Telephone Number	:	516-477-2430
Fax Number	:	516-280-8466

Provider Business Practice Location Address
First Line	:	1 BARSTOW RD STE P10
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-3501
Country	:	US
Telephone Number	:	516-477-2430
Fax Number	:	516-280-8466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	02/25/2026

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