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General NPI Number Information
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NPI Number | 1386647105
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Entity Type | Organization
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Legal Business Name | KAY & TABAS OPHTHALMOLOGY ASSOCIATES
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 601 WALNUT ST STE 210W
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3323
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Country | US
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Telephone | 215-925-6402
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Fax | 215-925-0262
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Provider Business Mailing Address
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Address Line | 601 WALNUT ST STE 210W
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3323
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Country | US
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Telephone | 215-925-6402
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Fax | 215-925-0262
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Authorized Official
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Title or Position | OWNER/ OPHTHALMOLOGIST
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Name | MICHAEL LEON KAY
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Credential | M.D.
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Telephone | 215-925-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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