Provider Demographics
NPI:1689007478
Name:KRAY, LAUREN M (PTA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:M
Last Name:KRAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 EGGERT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4148
Mailing Address - Country:US
Mailing Address - Phone:716-831-8422
Mailing Address - Fax:716-831-8428
Practice Address - Street 1:1085 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4148
Practice Address - Country:US
Practice Address - Phone:716-831-8422
Practice Address - Fax:716-831-8428
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8948-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8948-1Medicaid