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NPI Code Detail

MEDICARE: TIMOTHY C. RAY NP

MEDICARE: TIMOTHY C. RAY NP
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
1363LF0000XFamily Nurse PractitionerNP-05066OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689661118
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY C. RAY NP
Provider Business Mailing Address
First Line : 25301 EUCLID AVE
Second Line :
City : EUCLID
State : OH
Zip : 44117-2609
Country : US
Telephone Number : 216-261-6263
Fax Number : 216-261-4964
Provider Business Practice Location Address
First Line : 25301 EUCLID AVE
Second Line :
City : EUCLID
State : OH
Zip : 44117-2609
Country : US
Telephone Number : 216-261-6263
Fax Number : 216-261-4964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 07/08/2007

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