MEDICARE: DR. MARC CHRISTIAN KAY DMD

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	1223P0300X	Periodontics	062000	NY
2	122300000X	Dentist	22DI02746900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22DI02746900	OTHER	NJ	NEW JERSEY BOARD OF DENTISTRY

General Provider Information

NPI Number	:	1710588066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC CHRISTIAN KAY DMD

Provider Business Mailing Address
First Line	:	340 W 28TH ST APT 9J
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-4741
Country	:	US
Telephone Number	:	917-436-0832
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 RTE 130
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-3000
Country	:	US
Telephone Number	:	267-469-0016
Fax Number	:

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

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	09/17/2021

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