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General NPI Number Information
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NPI Number | 1063873222
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Entity Type | Individual
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Provider Name | SUSAN JO GRAY APN
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Gender | Female
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 190 HIGHWAY 31 STE 100
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City | FLEMINGTON
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State | NJ
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Zip | 08822-5773
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Country | US
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Telephone | 908-788-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 215 STATE ROUTE 31 RM 116
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City | FLEMINGTON
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State | NJ
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Zip | 08822-5752
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Country | US
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Telephone | 908-284-1125
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Fax | 908-284-2016
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 26NJ00604400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 26NJ00604400
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License Number State | NJ
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