MEDICARE: CHERYL ANN WRAY MA

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	237600000X	Audiologist-Hearing Aid Fitter	2101 001409	VA
2	231H00000X	Audiologist	2201001176	VA

General Provider Information

NPI Number	:	1356383558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL ANN WRAY MA

Provider Business Mailing Address
First Line	:	860 OMNI BLVD
Second Line	:	STE 101
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4430
Country	:	US
Telephone Number	:	757-232-8769
Fax Number	:	757-232-8875

Provider Business Practice Location Address
First Line	:	5818 HARBOUR VIEW BLVD STE 230D
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23435-3315
Country	:	US
Telephone Number	:	757-673-6118
Fax Number	:	757-967-9003

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	03/06/2020

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Directions to “ CHERYL ANN WRAY MA” Practice Location

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