Basic Information
| Provider Information | |||||||||
| NPI: | 1326123787 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLAINBARD | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 BARTOW AVE | ||||||||
| Address2: | SUITE 311 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104754614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183205300 | ||||||||
| FaxNumber: | 7183201116 | ||||||||
| Practice Location | |||||||||
| Address1: | MMG - CO-OP CITY | ||||||||
| Address2: | 2100 BARTOW AVENUE, STE. 311 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183205300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 01/22/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 129389 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.