Individual
PETER ANTHONY KELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44 ROUTE 114, SHELTER ISLAND, NY 11964-0880
(631) 749-9130
(631) 749-9134
Mailing address
44 SOUTH FERRY ROAD, BOX 880, SHELTER ISLAND, NY 11964-0880
(631) 749-9130
(631) 749-9134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
153757-1
NY
208D00000X
General Practice Physician
Primary
153757-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00789524
—
NY
Enumeration date
02/14/2006
Last updated
02/09/2022
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