Provider Demographics
NPI:1114915709
Name:KAYE, BARRY N (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:N
Last Name:KAYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2964
Mailing Address - Country:US
Mailing Address - Phone:617-484-2552
Mailing Address - Fax:
Practice Address - Street 1:19 NORWOOD ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-2709
Practice Address - Country:US
Practice Address - Phone:617-394-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-09
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJ02832OtherBCBS
MA709832OtherTUFTS
MA6190227Medicaid
MDJ02832OtherBCBS
J02832Medicare ID - Type Unspecified