Provider Demographics
NPI:1982854758
Name:BRAY, ROBIN J (MA,CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:J
Last Name:BRAY
Suffix:
Gender:F
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 HENRY HUDSON PKWY
Mailing Address - Street 2:SUITE #11
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3224
Mailing Address - Country:US
Mailing Address - Phone:718-884-7111
Mailing Address - Fax:718-884-7119
Practice Address - Street 1:3333 HENRY HUDSON PKWY
Practice Address - Street 2:SUITE #11
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3224
Practice Address - Country:US
Practice Address - Phone:718-884-7111
Practice Address - Fax:718-884-7119
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001752-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist