Provider Demographics
NPI:1114108107
Name:RAY, ALLISON CARRIE (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:CARRIE
Last Name:RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1824 GOOD HOPE ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1233
Mailing Address - Country:US
Mailing Address - Phone:717-791-2680
Mailing Address - Fax:717-791-2686
Practice Address - Street 1:1824 GOOD HOPE ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1233
Practice Address - Country:US
Practice Address - Phone:717-791-2680
Practice Address - Fax:717-791-2686
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-18
Last Update Date:2023-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD434001208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021730870001Medicaid