Healthcare Provider Details

I. General information

NPI: 1093204372
Provider Name (Legal Business Name): LAUREN ELIZABETH GRAY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER-PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOS022623
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: