Provider Demographics
NPI:1235271438
Name:SHRAY, JAY D (PA-C)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:D
Last Name:SHRAY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:95 COLLIER RD NW
Mailing Address - Street 2:SUITE 2035
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1796
Mailing Address - Country:US
Mailing Address - Phone:404-605-2800
Mailing Address - Fax:404-351-5983
Practice Address - Street 1:95 COLLIER RD NW
Practice Address - Street 2:SUITE 2035
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1796
Practice Address - Country:US
Practice Address - Phone:404-605-2800
Practice Address - Fax:404-351-5983
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA052265363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003106372AMedicaid
GA202I974739Medicare PIN