Provider Demographics
NPI:1700951589
Name:KAYE, ALISSA (MD)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:KAYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2843
Mailing Address - Country:US
Mailing Address - Phone:908-272-8676
Mailing Address - Fax:908-272-3544
Practice Address - Street 1:31 S UNION AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2843
Practice Address - Country:US
Practice Address - Phone:908-272-8676
Practice Address - Fax:908-272-3544
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07741000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI22215Medicare UPIN
NJ086398Medicare ID - Type UnspecifiedGROUP
NJ086239TLCMedicare ID - Type UnspecifiedINDIVIDUAL