Provider Demographics
NPI:1467402560
Name:RAY, DANI (MD)
Entity Type:Individual
Prefix:DR
First Name:DANI
Middle Name:
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABODE
Other - Middle Name:L
Other - Last Name:HAMOUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:74 PENNIMAN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-7008
Mailing Address - Country:US
Mailing Address - Phone:617-816-7366
Mailing Address - Fax:
Practice Address - Street 1:52 OAK ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2078
Practice Address - Country:US
Practice Address - Phone:774-213-9088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2267192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAHA-A39586Medicare ID - Type Unspecified