NPI 1285644039 · live from the CMS NPI Registry
Jennifer P Gray, MD
Dermatology in Old Saybrook, CT. National Provider Identifier 1285644039, active.
NPI record
| NPI | 1285644039 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 455 Boston Post Rd, Suite 10, Old Saybrook, CT 06475 |
| Practice phone | 860-388-9799 |
| Enumerated | August 8, 2006 |
| Last updated | February 17, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | 11512 (RI) |
| Dermatology primary | 207N00000X | 044955 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.