Basic Information
| Provider Information | |||||||||
| NPI: | 1699752048 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SETHI | ||||||||
| FirstName: | KHALID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33 LEWIS RD | ||||||||
| Address2: | 2ND FL | ||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139051040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077298156 | ||||||||
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| Practice Location | |||||||||
| Address1: | 46 HARRISON ST | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 137902142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077294942 | ||||||||
| FaxNumber: | 6077297516 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 07/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MD473553 | PA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 224683 | NY | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000142716 | 01 | NY | BS/HMO | OTHER | 02317206 | 05 | NY | MEDICAID | 2958184 | 01 | NY | AETNA/HMO | OTHER | 7800361 | 01 | NY | AETNA/PPO-POS | OTHER | 140008348 | 01 | GA | RAILROAD MEDICARE | OTHER |