Provider Demographics
NPI:1629307491
Name:KAY, BURTON JORDAN (MD)
Entity Type:Individual
Prefix:
First Name:BURTON
Middle Name:JORDAN
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 1:3 SCR LANE
Mailing Address - Street 2:
Mailing Address - City:VICTOR,
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9631
Mailing Address - Country:US
Mailing Address - Phone:585-425-1157
Mailing Address - Fax:
Practice Address - Street 1:3 SCR LANE
Practice Address - Street 2:
Practice Address - City:VICTOR,
Practice Address - State:NY
Practice Address - Zip Code:14564-9631
Practice Address - Country:US
Practice Address - Phone:585-425-1157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093237-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist