Dr. Jake Alexander Kleinmahon, MD
Pediatrics, Pediatric Cardiology in New Hyde Park, NY. Individual provider (NPI-1).
NPI number1629368014
StatusActive
Last updated in NPPESJan 20, 2025
Details
- NPI
- 1629368014
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jake Alexander Kleinmahon
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2011
- Certification date
- Jan 20, 2025
- Last updated
- Jan 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0202X | Pediatrics, Pediatric Cardiology | 325391 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1111 Marcus Ave Ste M15New Hyde Park, NY 11042-1034
Phone 516-601-7200
Mailing address
9 Canterbury LnRoslyn Heights, NY 11577-1401
Phone 914-420-4678
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