MEDICARE: KAY & TABAS OPHTHALMOLOGY ASSOCIATES

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	152W00000X	Optometrist
2	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1386647105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAY & TABAS OPHTHALMOLOGY ASSOCIATES

Provider Business Mailing Address
First Line	:	601 WALNUT ST STE 210W
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3323
Country	:	US
Telephone Number	:	215-925-6402
Fax Number	:	215-925-0262

Provider Business Practice Location Address
First Line	:	601 WALNUT ST STE 210W
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3323
Country	:	US
Telephone Number	:	215-925-6402
Fax Number	:	215-925-0262

Authorized Official
Title or Position	:	OWNER/ OPHTHALMOLOGIST
Name	:	MICHAEL LEON KAY
Credential	:	M.D.
Telephone Number	:	215-925-6402

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	09/02/2020

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