Provider Demographics
NPI:1033538350
Name:GRAY, IGA N (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:IGA
Middle Name:N
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:FL 3
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:800-448-6767
Mailing Address - Fax:215-339-8103
Practice Address - Street 1:2610 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-5104
Practice Address - Country:US
Practice Address - Phone:800-448-6767
Practice Address - Fax:215-339-8103
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.024251207R00000X
CAA174875207W00000X
PAMD464320207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine