1427188317 NPI number — SCOTT H. KAYE DPM PC

Table of content: (NPI 1427188317)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427188317 NPI number — SCOTT H. KAYE DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCOTT H. KAYE DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427188317
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1842 BEACON ST
Provider Second Line Business Mailing Address:
SUITE 207
Provider Business Mailing Address City Name:
BROOKLINE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02445-1930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-734-1414
Provider Business Mailing Address Fax Number:
617-734-0098

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1842 BEACON ST
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
BROOKLINE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02445-1930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-734-1414
Provider Business Practice Location Address Fax Number:
617-734-0098
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KAYE
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PROPRIETOR
Authorized Official Telephone Number:
617-734-1414

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  1671 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: 1671 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9773886 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2700016 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: CA2745 . This is a "PALMETTO GBA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 717729 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA11526 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y77143 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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