Provider Demographics
NPI:1477106789
Name:DR. JEFF DRAYER, LLC
Entity Type:Organization
Organization Name:DR. JEFF DRAYER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-297-0291
Mailing Address - Street 1:559 FOUNDRY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1357
Mailing Address - Country:US
Mailing Address - Phone:508-297-0291
Mailing Address - Fax:508-297-2468
Practice Address - Street 1:559 FOUNDRY ST
Practice Address - Street 2:
Practice Address - City:SOUTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02375-1357
Practice Address - Country:US
Practice Address - Phone:508-297-0291
Practice Address - Fax:508-297-2468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty