Provider Demographics
NPI:1467441972
Name:KAY, MICHAEL LEON (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEON
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 1:601 WALNUT ST STE 210W
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3323
Mailing Address - Country:US
Mailing Address - Phone:215-925-6402
Mailing Address - Fax:215-925-0262
Practice Address - Street 1:601 WALNUT ST STE 210W
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3323
Practice Address - Country:US
Practice Address - Phone:215-925-6402
Practice Address - Fax:215-925-0262
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012768E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0718845/01Medicaid
PA178022FLBMedicare ID - Type Unspecified