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NPI Code Detail

MEDICARE: DR. KELLY C STETS M.D.

MEDICARE: DR. KELLY C STETS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician240786NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245498278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY C STETS M.D.
Provider Business Mailing Address
First Line : 55 WATER ST
Second Line : 12TH FLOOR, CREDENTIALING
City : NEW YORK
State : NY
Zip : 10041-0004
Country : US
Telephone Number : 646-680-2888
Fax Number : 516-542-5556
Provider Business Practice Location Address
First Line : 3245 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3716
Country : US
Telephone Number : 718-615-3777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 11/22/2021

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Directions to “ DR. KELLY C STETS M.D.” Practice Location

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