1427248434 NPI number — MRS. MARGARET ELLEN GRAY APN-C

Table of content: MRS. MARGARET ELLEN GRAY APN-C (NPI 1427248434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427248434 NPI number — MRS. MARGARET ELLEN GRAY APN-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAY
Provider First Name:
MARGARET
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHLECK
Provider Other First Name:
MARGARET
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427248434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 FEDERAL ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMDEN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08103-1088
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
848-288-6935
Provider Business Mailing Address Fax Number:
732-790-0107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
504 WHITE HORSE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HADDON HEIGHTS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08035-1709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-546-7990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SA2200X , with the licence number:  26NJ00137700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 26NJ00137700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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