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DR. ETHAN KIDDE MD
NPI 1851094031
Student in an Organized Health Care Education/Training Program in Stony Brook, NY

Active since March 24, 2023
HEALTH SCIENCES CENTER T12-033A, STONY BROOK, NY 11794(631) 444-7878 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Ethan Kidde Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN KIDDE MD (NPI 1851094031) is an individual student in an organized health care education/training program in Stony Brook, New York and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1851094031
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. ETHAN KIDDECredential: MD
Location AddressHEALTH SCIENCES CENTER T12-033AStony Brook, NY 11794-0001
Mailing AddressHealth Sciences Center T12-020Stony Brook, NY 11794-0001 · (631) 444-7878 · Fax (631) 706-4484
Phone(631) 444-7878
Sole ProprietorNo
Enumeration DateMarch 24, 2023
NPPES CertifiedMarch 24, 2023
✔ NPI 1851094031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
HEALTH SCIENCES CENTER T12-033A, Stony Brook, NY 11794
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DOMINICK J CALAVANO MD
Student in an Organized Health Care Education/Training Program
HEALTH SCIENCES CENTER T12-033A
STONY BROOK, NY 11794
Suffolk County (631) 444-7878
AUDREY YAN DO
Student in an Organized Health Care Education/Training Program
HEALTH SCIENCES CENTER T12-033A
STONY BROOK, NY 11794
Suffolk County (631) 444-7878

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Kidde's NPI number?

The NPI number for Ethan Kidde is 1851094031. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Ethan Kidde located?

Ethan Kidde practices at Health Sciences Center T12-033a, Stony Brook, NY 11794. The listed phone number is (631) 444-7878.

What is Ethan Kidde's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Ethan Kidde was last updated on March 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.