MEDICARE: DAVID LORAY PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15506600	NJ
2	163W00000X	Registered Nurse	26NR18634800	NJ

General Provider Information

NPI Number	:	1033691167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LORAY PMHNP-BC

Provider Business Mailing Address
First Line	:	172 RIVEREDGE RD
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-2751
Country	:	US
Telephone Number	:	908-514-1710
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 IRON BRIDGE RD STE 6
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-5305
Country	:	US
Telephone Number	:	732-761-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2018
Last Update Date	:	06/23/2026

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