MEDICARE: JUDITH KLEINERMAN M.D.

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	207RH0003X	Hematology & Oncology Physician	79043	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3000330	OTHER	MA	UNITED HEALTH PLANS
2	J31588	OTHER	MA	BLUE SHIELD OF MASS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	768799	OTHER	MA	TUFTS HEALTH PLAN
5	65872	OTHER	MA	HARVARD PILGRIM HEATLH CA

General Provider Information

NPI Number	:	1669453999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH KLEINERMAN M.D.

Provider Business Mailing Address
First Line	:	72 WASHINGTON ST
Second Line	:	SUITE 1300
City	:	TAUNTON
State	:	MA
Zip	:	02780-2491
Country	:	US
Telephone Number	:	508-824-5865
Fax Number	:	508-823-9108

Provider Business Practice Location Address
First Line	:	72 WASHINGTON ST
Second Line	:	SUITE 1300
City	:	TAUNTON
State	:	MA
Zip	:	02780-2491
Country	:	US
Telephone Number	:	508-824-5865
Fax Number	:	508-823-9108

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	12/11/2007

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