Provider Demographics
NPI:1699023168
Name:GRAY, ANALIA BAPTISTA (NP)
Entity Type:Individual
Prefix:MS
First Name:ANALIA
Middle Name:BAPTISTA
Last Name:GRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ANALIA
Other - Middle Name:BAPTISTA
Other - Last Name:XAVIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 CEDARHURST LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-2723
Mailing Address - Country:US
Mailing Address - Phone:203-895-4360
Mailing Address - Fax:
Practice Address - Street 1:135 CEDARHURST LN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-2723
Practice Address - Country:US
Practice Address - Phone:203-895-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005026363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health