Provider Demographics
NPI:1609371020
Name:GRAY, ALISON K (LPN)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:K
Last Name:GRAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:K
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICENSED NURSE
Mailing Address - Street 1:156 E 54TH ST APT 4D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3632
Mailing Address - Country:US
Mailing Address - Phone:917-476-9099
Mailing Address - Fax:
Practice Address - Street 1:156 E 54TH ST APT 4D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3632
Practice Address - Country:US
Practice Address - Phone:917-476-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325096164W00000X, 101YA0400X, 2080P0006X, 253Z00000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child