Provider Demographics
NPI:1699752048
Name:SETHI, KHALID (MD)
Entity type:Individual
Prefix:DR
First Name:KHALID
Middle Name:
Last Name:SETHI
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 1:1020 VESTAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1748
Mailing Address - Country:US
Mailing Address - Phone:607-444-6868
Mailing Address - Fax:
Practice Address - Street 1:1020 VESTAL PKWY E
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1748
Practice Address - Country:US
Practice Address - Phone:607-444-6868
Practice Address - Fax:607-444-8618
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473553207T00000X
NY224683207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7800361OtherAETNA/PPO-POS
NY02317206Medicaid
NY000142716OtherBS/HMO
GA140008348OtherRAILROAD MEDICARE
NY2958184OtherAETNA/HMO
NYH70815Medicare UPIN
NYDD2413Medicare ID - Type Unspecified