Individual
BURGANDY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3005 WATKINS RD, HORSEHEADS, NY 14845-1800
(607) 739-8711
Mailing address
571 SAINT JOSEPHS BLVD, FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018372
NY
363A00000X
Physician Assistant
MA057364
PA
Other
Enumeration date
01/07/2015
Last updated
03/14/2019
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