Provider Demographics
NPI:1447706783
Name:ANNMARIE RAY
Entity type:Organization
Organization Name:ANNMARIE RAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-622-2516
Mailing Address - Street 1:274 THIRD STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2333
Mailing Address - Country:US
Mailing Address - Phone:724-770-9006
Mailing Address - Fax:724-770-9906
Practice Address - Street 1:274 THIRD STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2333
Practice Address - Country:US
Practice Address - Phone:724-770-9006
Practice Address - Fax:724-770-9906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042379L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty