Provider Demographics
NPI:1639297666
Name:KAYE, JOEL L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:L
Last Name:KAYE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:352 MONTAUK HIGHWAY
Mailing Address - City:WAINSCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:11975-0695
Mailing Address - Country:US
Mailing Address - Phone:917-673-4362
Mailing Address - Fax:
Practice Address - Street 1:352 MONTAUK HIGHWAY
Practice Address - Street 2:WAINSCOTT OFFICES
Practice Address - City:WAINSCOTT
Practice Address - State:NY
Practice Address - Zip Code:11975-0695
Practice Address - Country:US
Practice Address - Phone:917-673-4362
Practice Address - Fax:631-537-1831
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02413207Medicaid
NYVM3221Medicare ID - Type UnspecifiedSINCE AUGUST, 2003