Provider Demographics
NPI:1760452809
Name:KITAY, STEVEN ELLIOT (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ELLIOT
Last Name:KITAY
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 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11800 ROCK LANDING DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4206
Practice Address - Country:US
Practice Address - Phone:757-643-8800
Practice Address - Fax:757-643-8919
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231489207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA180044905Medicare PIN
VA1760452809Medicaid
VA1081570011Medicare NSC
G28218Medicare UPIN
VA015826R53Medicare PIN