Provider Demographics
NPI:1649420431
Name:GRAY, JOYA
Entity Type:Individual
Prefix:
First Name:JOYA
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07063-1658
Mailing Address - Country:US
Mailing Address - Phone:732-763-7178
Mailing Address - Fax:732-763-7178
Practice Address - Street 1:169 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07063-1658
Practice Address - Country:US
Practice Address - Phone:732-763-7178
Practice Address - Fax:732-763-7178
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052776001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical