Provider Demographics
NPI:1467528703
Name:SETH, KAVITA (DO)
Entity Type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:
Last Name:SETH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAVITA
Other - Middle Name:
Other - Last Name:SHROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 IRVING AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1529
Mailing Address - Country:US
Mailing Address - Phone:315-656-8750
Mailing Address - Fax:315-656-8490
Practice Address - Street 1:5900 N BURDICK ST
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9462
Practice Address - Country:US
Practice Address - Phone:315-656-8750
Practice Address - Fax:315-656-8490
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2352362080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
11851346OtherCAQH