Individual
MR. JONATHAN GARDNER GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-7739
Mailing address
11 NEVINS ST, SUITE 306, BOSTON, MA 02135-3514
(617) 789-2045
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2275
MA
363AS0400X
Surgical Physician Assistant
2275
MA
Other
Enumeration date
04/07/2008
Last updated
05/01/2019
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