Healthcare Provider Details

I. General information

NPI: 1871666537
Provider Name (Legal Business Name): RICHARD A KAY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MAIN ST
COLEBROOK NH
03576-3066
US

IV. Provider business mailing address

108 MAIN ST
COLEBROOK NH
03576-3066
US

V. Phone/Fax

Practice location:
  • Phone: 603-237-8777
  • Fax:
Mailing address:
  • Phone: 603-237-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0416
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: