Individual
DR. SANDRA C KELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT005605-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17390P
HIP
NY
01
—
2508518
AETNA US HEALTH HMO
NY
01
—
3C0168
HEALTHNET OF THE NORTHEAS
NY
01
—
4242180001
MED DURABLE MEDICAL EQUIP
NY
01
—
5714530
AETNA US HEALTH PPO
NY
01
—
597002
MVP
NY
01
—
C23392
EMPIRE BLUE CROSS/SHIELD
NY
01
—
P-11097425
MULTIPLAN
NY
01
—
P677288
OXFORD
NY
Enumeration date
09/12/2006
Last updated
11/15/2007
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