Provider Demographics
NPI:1215150776
Name:RAY, CLINTON A II (LPN)
Entity type:Individual
Prefix:MR
First Name:CLINTON
Middle Name:A
Last Name:RAY
Suffix:II
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 MT PLEASANT AVE
Mailing Address - Street 2:UNIT 6
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052
Mailing Address - Country:US
Mailing Address - Phone:862-216-7536
Mailing Address - Fax:
Practice Address - Street 1:261 CONNECTICUT DRIVE
Practice Address - Street 2:SUITE 5 GENERAL HEALTHCARE RESOURCES
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016
Practice Address - Country:US
Practice Address - Phone:800-950-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ264P05107200164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse