Provider Demographics
NPI:1073010559
Name:KAYE, SCOTT PAUL (RN)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:PAUL
Last Name:KAYE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 CLEARVIEW EXPY
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3109
Mailing Address - Country:US
Mailing Address - Phone:917-365-5839
Mailing Address - Fax:
Practice Address - Street 1:4545 CLEARVIEW EXPY
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3109
Practice Address - Country:US
Practice Address - Phone:917-365-5839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY555812163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse