Provider Demographics
NPI:1407937832
Name:KAY, DAVID PAUL (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:KAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2216
Mailing Address - Country:US
Mailing Address - Phone:413-528-2880
Mailing Address - Fax:413-528-5957
Practice Address - Street 1:789 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2216
Practice Address - Country:US
Practice Address - Phone:413-528-2880
Practice Address - Fax:413-528-5957
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2875152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0339539Medicaid
MA0339539Medicaid
MA0339539Medicaid
MA186358Medicare ID - Type Unspecified