Provider Demographics
NPI:1891107694
Name:RAY, DEVA (LPN)
Entity Type:Individual
Prefix:MS
First Name:DEVA
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:EVA
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 DEBS PL APT 23C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-2528
Mailing Address - Country:US
Mailing Address - Phone:516-724-4805
Mailing Address - Fax:
Practice Address - Street 1:2054 TILLOTSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1560
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health