Provider Demographics
NPI:1992809594
Name:RAY, DEBRA M (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STATE ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1462
Mailing Address - Country:US
Mailing Address - Phone:732-222-1711
Mailing Address - Fax:732-222-2060
Practice Address - Street 1:100 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1462
Practice Address - Country:US
Practice Address - Phone:732-222-1711
Practice Address - Fax:732-222-2060
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04608500207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2264706Medicaid
NJ2264706Medicaid
NJ461798AFCMedicare ID - Type Unspecified