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Contact Information

LARISA V KLEYMENOVA, MD
5115 BEACH CHANNEL DR
FAR ROCKAWAY, NY11691-1042
 Phone: 212-563-2627
 Fax: 212-563-0605
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for LARISA V KLEYMENOVA · (Female)

NPI Number 1841325339
Status Active
Credentials MD
Entity Individual
Enumeration date 02/23/2007
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 230116
  • NY Medicaid 02498626
Hospital affiliation(s)
  • NASSAU UNIVERSITY MEDICAL CENTER - (Acute Care)
    2201 HEMPSTEAD TURNPIKE
    EAST MEADOW, NY 11554
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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