Provider Demographics
NPI:1063408987
Name:KLEINER, ROBERT C (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:KLEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:124 DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1853
Mailing Address - Country:US
Mailing Address - Phone:215-699-7600
Mailing Address - Fax:215-699-4758
Practice Address - Street 1:124 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1853
Practice Address - Country:US
Practice Address - Phone:215-699-7600
Practice Address - Fax:215-699-4758
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028767E207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1092750Medicaid
402598Medicare ID - Type Unspecified
B41235Medicare UPIN