Individual
DIANE S GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4730
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0394742
MEDICAID WELFARE
—
05
—
0394742
—
MA
01
—
042472266
HEALTHCARE VALUE MANAGEME
—
01
—
115682
FALLON COMMUNITY HEALTH P
—
01
—
650017524
RAILROAD MEDICARE
—
01
—
Y67942
BLUE CROSS
—
Enumeration date
08/19/2006
Last updated
01/18/2016
Update your record
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