Provider Demographics
NPI:1326381666
Name:GRAY, COURTNEY CHRISTINE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:CHRISTINE
Last Name:GRAY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:100 ROUTE 59
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4927
Mailing Address - Country:US
Mailing Address - Phone:845-357-5775
Mailing Address - Fax:845-357-5777
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:ANESTHESIA OFFICE
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-368-5039
Practice Address - Fax:845-368-5327
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2016-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY629650367500000X
MARN275723367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered