Provider Demographics
NPI:1720849185
Name:KAY, FORDE
Entity Type:Individual
Prefix:MR
First Name:FORDE
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 1:6700 KIRKVILLE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9382
Mailing Address - Country:US
Mailing Address - Phone:401-742-1637
Mailing Address - Fax:
Practice Address - Street 1:6700 KIRKVILLE RD STE 107
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9382
Practice Address - Country:US
Practice Address - Phone:401-742-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist