Provider Demographics
NPI:1376576116
Name:KAYE, STEVEN (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KAYE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9553 W BLUE SKY DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-8741
Mailing Address - Country:US
Mailing Address - Phone:623-703-0847
Mailing Address - Fax:
Practice Address - Street 1:8685 W UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-7006
Practice Address - Country:US
Practice Address - Phone:623-486-2331
Practice Address - Fax:623-486-3136
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2213174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ2213OtherPT LICENSE NUMBER