Provider Demographics
NPI:1063546190
Name:KLEYNERMAN, LANA (MD)
Entity type:Individual
Prefix:DR
First Name:LANA
Middle Name:
Last Name:KLEYNERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3014
Mailing Address - Country:US
Mailing Address - Phone:718-743-3856
Mailing Address - Fax:
Practice Address - Street 1:51 CHARLES LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3658
Practice Address - Country:US
Practice Address - Phone:516-228-6208
Practice Address - Fax:516-794-2014
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1668989291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory