Provider Demographics
NPI:1558998229
Name:LONGORIA-GRAY, KATARINA ALEXANDRIA (MD)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:ALEXANDRIA
Last Name:LONGORIA-GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KATARINA
Other - Middle Name:ALEXANDRIA
Other - Last Name:LONGORIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1215 LEE ST.
Mailing Address - Street 2:MAIL STOP 800719
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-924-2150
Mailing Address - Fax:434-924-6805
Practice Address - Street 1:1215 LEE ST.
Practice Address - Street 2:MAIL STOP 800719
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-924-2150
Practice Address - Fax:434-924-6805
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116034258207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology