Provider Demographics
NPI:1306272919
Name:GRAY, DONALD
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:GRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HENRY ST
Mailing Address - Street 2:#4D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2566
Mailing Address - Country:US
Mailing Address - Phone:212-989-2990
Mailing Address - Fax:212-792-6058
Practice Address - Street 1:50 W 23RD ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5205
Practice Address - Country:US
Practice Address - Phone:212-989-2990
Practice Address - Fax:212-792-6058
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health