1316966807 NPI number — DR. STEVEN P KALLET M.D.

Table of content: DR. STEVEN P KALLET M.D. (NPI 1316966807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316966807 NPI number — DR. STEVEN P KALLET M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALLET
Provider First Name:
STEVEN
Provider Middle Name:
P
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316966807
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E 77TH ST
Provider Second Line Business Mailing Address:
4TH FLOOR, EAST BUILDING
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10075-1850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-434-3620
Provider Business Mailing Address Fax Number:
212-434-3799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E 77TH ST
Provider Second Line Business Practice Location Address:
4TH FLOOR, EAST BUILDING
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10075-1850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-434-3620
Provider Business Practice Location Address Fax Number:
212-434-3799
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  115942 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 133451387 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 133451387 . This is a "EMPIRE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2964005 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4097529 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2C2113 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: NS518 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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