Provider Demographics
NPI:1972604536
Name:KAYE, MICHAEL JON (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JON
Last Name:KAYE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LIFEMARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960
Mailing Address - Country:US
Mailing Address - Phone:215-258-0155
Mailing Address - Fax:215-258-0112
Practice Address - Street 1:3 LIFEMARK DRIVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960
Practice Address - Country:US
Practice Address - Phone:215-258-0155
Practice Address - Fax:215-258-0112
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005367L111N00000X
PA229111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01544651Medicaid
PA01544651Medicaid
U43812Medicare UPIN