Healthcare Provider Details

I. General information

NPI: 1053128264
Provider Name (Legal Business Name): CATHERINE RAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

4815 LIBERTY AVE
PITTSBURGH PA
15224-2156
US

V. Phone/Fax

Practice location:
  • Phone: 877-497-8093
  • Fax:
Mailing address:
  • Phone: 302-733-4186
  • Fax: 302-733-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012152
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: