Individual
DR. JENNIFER MARIE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6012
(631) 474-6448
Mailing address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6012
(631) 474-6448
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
256760
NY
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
256760
NY
Other
Enumeration date
09/22/2008
Last updated
04/09/2012
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