Provider Demographics
NPI:1467504928
Name:DAYE, KATHLEEN (MD)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:DAYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SOUTH MAIN STREET
Mailing Address - Street 2:VERMONT STATE HOSPITAL
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05671-2501
Mailing Address - Country:US
Mailing Address - Phone:802-241-1000
Mailing Address - Fax:802-241-1439
Practice Address - Street 1:103 SOUTH MAIN STREET
Practice Address - Street 2:VERMONT STATE HOSPITAL
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05671-2501
Practice Address - Country:US
Practice Address - Phone:802-241-1000
Practice Address - Fax:802-241-1439
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420006677208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0005382Medicaid
VT0005382Medicaid
B85755Medicare UPIN