Individual
KAYE ANNE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 CENTER ST, MASSENA, NY 13662-1437
(315) 764-0265
(315) 764-1812
Mailing address
22 CENTER ST, PO BOX 111, MASSENA, NY 13662-1437
(315) 764-0265
(315) 764-1812
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
207013-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01775626
—
NY
Enumeration date
07/12/2006
Last updated
02/21/2008
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