Provider Demographics
NPI:1447625652
Name:GRAY, SERAP
Entity type:Individual
Prefix:
First Name:SERAP
Middle Name:
Last Name:GRAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-339-2704
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:1 OLYMPIC PL
Practice Address - Street 2:SUITE 200, TOWSON UNIVERSITY
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4104
Practice Address - Country:US
Practice Address - Phone:410-704-7300
Practice Address - Fax:410-704-6303
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07837225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist