Provider Demographics
NPI:1902884505
Name:KAIN, JAY B (PT)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:B
Last Name:KAIN
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:789 MAIN STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2217
Mailing Address - Country:US
Mailing Address - Phone:413-528-0929
Mailing Address - Fax:413-528-6123
Practice Address - Street 1:789 MAIN STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:GT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2217
Practice Address - Country:US
Practice Address - Phone:413-528-0929
Practice Address - Fax:413-528-6123
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA4319225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQX4679Medicare PIN
MAY65217Medicare ID - Type Unspecified