Provider Demographics
NPI:1053675207
Name:KESHET, ITAY (MD)
Entity type:Individual
Prefix:
First Name:ITAY
Middle Name:
Last Name:KESHET
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 1:71 SCHOLES ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-1847
Mailing Address - Country:US
Mailing Address - Phone:347-286-8169
Mailing Address - Fax:
Practice Address - Street 1:8115 161ST ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:347-286-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD460552084A2900X
NC2020-033712084A2900X
FLME-1458322084A2900X
MN653162084A2900X
CAA1430242084A2900X
MT686432084N0400X
WI707632084N0400X
OH35.1349802084N0400X
NY2851202084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology