Provider Demographics
NPI:1134182785
Name:GRAY, ELISABETH MORGAN (MD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:MORGAN
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:GRAY
Other - Last Name:BISCHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:305 CLINTON ST
Mailing Address - Street 2:CTRC
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-2017
Mailing Address - Country:US
Mailing Address - Phone:607-797-0680
Mailing Address - Fax:607-797-4315
Practice Address - Street 1:305 CLINTON ST
Practice Address - Street 2:CTRC
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2017
Practice Address - Country:US
Practice Address - Phone:607-797-0680
Practice Address - Fax:607-797-4315
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2390292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry