Provider Demographics
NPI:1609317544
Name:KAY, CHAD
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:KAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 DUFFY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3653
Mailing Address - Country:US
Mailing Address - Phone:718-863-2277
Mailing Address - Fax:
Practice Address - Street 1:299 DUFFY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3653
Practice Address - Country:US
Practice Address - Phone:718-863-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-11
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ345PO00016600224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist