Provider Demographics
NPI:1003021064
Name:ANDERSON-RAY, JANET LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:LYNN
Last Name:ANDERSON-RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CHUCTA RD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-2240
Mailing Address - Country:US
Mailing Address - Phone:307-287-5611
Mailing Address - Fax:
Practice Address - Street 1:687 STRAITS TPKE STE 2A
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2846
Practice Address - Country:US
Practice Address - Phone:203-575-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7652A207V00000X
CT67565207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics