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General NPI Number Information
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NPI Number | 1730575655
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Entity Type | Organization
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Legal Business Name | MICHAEL R GRAY MD PC
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 2 W 46TH ST 506
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City | NEW YORK
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State | NY
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Zip | 10036-4811
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Country | US
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Telephone | 212-684-5477
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Fax | 917-591-1336
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Provider Business Mailing Address
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Address Line | 2 W 46TH ST 506
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City | NEW YORK
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State | NY
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Zip | 10036-4811
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Country | US
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Telephone | 212-684-5477
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Fax | 917-591-1336
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL ROBERT GRAY
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Credential | MD
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Telephone | 212-684-5477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 166679
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License Number State | NY
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