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NPI Code Detail

MEDICARE: MS. NIRA L. RAY MHS, PA-C

MEDICARE: MS. NIRA L. RAY MHS, PA-C
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
1363A00000XPhysician Assistant
2363A00000XPhysician Assistant6639CT

General Provider Information

NPI Number : 1871617142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NIRA L. RAY MHS, PA-C
Provider Business Mailing Address
First Line : 911 LAKEVILLE ST # 352
Second Line :
City : PETALUMA
State : CA
Zip : 94952-3329
Country : US
Telephone Number : 415-754-5584
Fax Number :
Provider Business Practice Location Address
First Line : 24 HOSPITAL AVE
Second Line :
City : DANBURY
State : CT
Zip : 06810-6077
Country : US
Telephone Number : 203-739-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 11/11/2024

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