MEDICARE: KAYS KAIDBEY M.D

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	207N00000X	Dermatology Physician	MD036673L	PA

General Provider Information

NPI Number	:	1255621603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYS KAIDBEY M.D

Provider Business Mailing Address
First Line	:	241 S 6TH ST
Second Line	:	APT. NUMBER2111
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3727
Country	:	US
Telephone Number	:	215-238-1225
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 S 6TH ST
Second Line	:	APT. NUMBER2111
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3727
Country	:	US
Telephone Number	:	215-238-1225
Fax Number	:

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

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	12/06/2014

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