Healthcare Provider Details

I. General information

NPI: 1467441972
Provider Name (Legal Business Name): MICHAEL LEON KAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WALNUT ST STE 210W
PHILADELPHIA PA
19106-3323
US

IV. Provider business mailing address

601 WALNUT ST STE 210W
PHILADELPHIA PA
19106-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-925-6402
  • Fax: 215-925-0262
Mailing address:
  • Phone: 215-925-6402
  • Fax: 215-925-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD012768E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: