Provider Demographics
NPI:1477789188
Name:GLEN S KAY MD PC
Entity Type:Organization
Organization Name:GLEN S KAY MD PC
Other - Org Name:OMNI MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-566-6664
Mailing Address - Street 1:1400 ROUTE 300
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2995
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 ROUTE 300
Practice Address - Street 2:SUITE 7
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2995
Practice Address - Country:US
Practice Address - Phone:845-566-6664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166913207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty