Provider Demographics
NPI:1164412839
Name:KAY, HOWARD H (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:H
Last Name:KAY
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 1:65 LIBBY ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2949
Mailing Address - Country:US
Mailing Address - Phone:508-584-6060
Mailing Address - Fax:508-584-4949
Practice Address - Street 1:65 LIBBY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2949
Practice Address - Country:US
Practice Address - Phone:508-584-6060
Practice Address - Fax:508-584-4949
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44123208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E03114Medicare UPIN