Provider Demographics
NPI:1447205190
Name:KAYE, ELAINE TRACY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:TRACY
Last Name:KAYE
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:65 WALNUT STREET STE 520
Mailing Address - Street 2:NEWTON WELLESLEY DERMATOLOGY ASSOCIATES
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:781-237-3500
Mailing Address - Fax:781-237-7867
Practice Address - Street 1:65 WALNUT STREET STE 520
Practice Address - Street 2:NEWTON WELLESLEY DERMATOLOGY ASSOCIATES
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-237-3500
Practice Address - Fax:781-237-7867
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA75461207N00000X, 207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
J12190Medicare ID - Type Unspecified
F22279Medicare UPIN