Provider Demographics
NPI:1497091607
Name:GRAY, DAMALI N (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DAMALI
Middle Name:N
Last Name:GRAY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-1201
Mailing Address - Country:US
Mailing Address - Phone:646-246-4427
Mailing Address - Fax:
Practice Address - Street 1:797 E 56TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1201
Practice Address - Country:US
Practice Address - Phone:646-246-4427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1376909077OtherNPPES