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General NPI Number Information
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NPI Number | 1538396254
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Entity Type | Individual
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Provider Name | EMILY L BRAY D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2009
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Last Update Date | 08/10/2017
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Provider Practice Location Address
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Address Line | 5501 OLD YORK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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Country | US
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Telephone | 215-456-9015
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Fax |
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Provider Business Mailing Address
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Address Line | 301 RACE ST #215
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1824
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Country | US
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Telephone | 610-248-4122
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Fax |
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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 | 16532
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License Number State | NH
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