MEDICARE: JAY B KAIN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	4319	MA

General Provider Information

NPI Number	:	1902884505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY B KAIN PT

Provider Business Mailing Address
First Line	:	789 MAIN STREET
Second Line	:	SUITE 4
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-2217
Country	:	US
Telephone Number	:	413-528-0929
Fax Number	:	413-528-6123

Provider Business Practice Location Address
First Line	:	789 MAIN STREET
Second Line	:	SUITE 4
City	:	GT BARRINGTON
State	:	MA
Zip	:	01230-2217
Country	:	US
Telephone Number	:	413-528-0929
Fax Number	:	413-528-6123

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/09/2016

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