Provider Demographics
NPI:1316966807
Name:KALLET, STEVEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:KALLET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 77TH ST
Mailing Address - Street 2:4TH FLOOR, EAST BUILDING
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1850
Mailing Address - Country:US
Mailing Address - Phone:212-434-3620
Mailing Address - Fax:212-434-3799
Practice Address - Street 1:100 E 77TH ST
Practice Address - Street 2:4TH FLOOR, EAST BUILDING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1850
Practice Address - Country:US
Practice Address - Phone:212-434-3620
Practice Address - Fax:212-434-3799
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115942208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
133451387OtherUNITED HEALTHCARE
133451387OtherEMPIRE PLAN
2964005OtherAETNA HMO
4097529OtherAETNA PPO
2C2113OtherHEALTHNET
NS518OtherOXFORD
NS518OtherOXFORD
133451387OtherUNITED HEALTHCARE
NY624001Medicare ID - Type Unspecified