Sandra Cammilleri Kellett OD, Faao, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT005605-1 Issued in NY

Legal business name

SANDRA CAMMILLERI KELLETT OD, FAAO, PC

Practice address

3630 Hill Blvd
Suite 303
Jefferson Valley, NY 10535-1505

Phone

(914) 962-8111

Fax

(914) 962-8160

NPI assigned

Nov 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra C KellettNPI 1174627715

Title

OD/Sole Owner

Phone

(914) 962-8111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra C Kellett, O.D.

  • Optometrist
  • Jefferson Valley, NY
  • NPI 1174627715
  Medicare reassignment NPD Authorized official
• Diane Suarez, OD

  • Optometrist
  • Ossining, NY
  • NPI 1568524502
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1639350911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 HILL BLVD",
            "address_2": "SUITE 303",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351505",
            "telephone_number": "914-962-8111",
            "fax_number": "914-962-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 HILL BLVD",
            "address_2": "SUITE 303",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351505",
            "telephone_number": "914-962-8111",
            "fax_number": "914-962-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA CAMMILLERI KELLETT OD, FAAO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "KELLETT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OD/SOLE OWNER",
        "authorized_official_telephone_number": "914-962-8111"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005605-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Janet Riordan, MSPT
• Justin Rudelli
• Dianne Ryan
• Ronald Mark Salon, MSW
• Gladys Sanchez
• Minerva Santos, M.D.
• Jeffrey Peter Schachne, M.D.
• Faith Schiff, OD
• Erin Grace Schmitt, MS, CCC-SLP
• John Daniel Scinto, MD

• Optometrist in Jefferson Valley, NY
• Providers in Jefferson Valley, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.