Provider Demographics
NPI:1790956993
Name:DR. STUART KITTON
Entity Type:Organization
Organization Name:DR. STUART KITTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-844-9490
Mailing Address - Street 1:41 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2613
Mailing Address - Country:US
Mailing Address - Phone:516-626-3999
Mailing Address - Fax:212-368-1513
Practice Address - Street 1:3410 BROADWAY # 18
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7400
Practice Address - Country:US
Practice Address - Phone:212-844-9490
Practice Address - Fax:212-368-1513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002750332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00415274Medicaid
NJ0539902Medicaid
NYT50873Medicare PIN
NJ0539902Medicaid
NYSK0P310010Medicare PIN
NJ443772Medicare PIN