Provider Demographics
NPI:1578015590
Name:GRAYMATTERS MEDICAL PRACTICE P.C.
Entity Type:Organization
Organization Name:GRAYMATTERS MEDICAL PRACTICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TEJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-740-5287
Mailing Address - Street 1:521 5TH AVE
Mailing Address - Street 2:SUITE 1722
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10175-0003
Mailing Address - Country:US
Mailing Address - Phone:917-740-5287
Mailing Address - Fax:888-396-3996
Practice Address - Street 1:521 5TH AVE
Practice Address - Street 2:SUITE 1722
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10175-0003
Practice Address - Country:US
Practice Address - Phone:917-740-5287
Practice Address - Fax:888-396-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty