MEDICARE: BLUE RAY ENTERPRISES LLC

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1306762539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE RAY ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	1064 CLINTON AVE STE 160
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3549
Country	:	US
Telephone Number	:	877-358-5111
Fax Number	:	908-858-5500

Provider Business Practice Location Address
First Line	:	1064 CLINTON AVE STE 160
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3549
Country	:	US
Telephone Number	:	877-358-5111
Fax Number	:	908-858-5500

Authorized Official
Title or Position	:	MANAGER
Name	:	SHAKYRRAH COVINGTON
Credential	:
Telephone Number	:	862-359-6560

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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Directions to “BLUE RAY ENTERPRISES LLC ” Practice Location

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