DR. ANDRE GRAY (NPI# 1144318510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144318510 |
| Entity Type | Individual |
| Full Name | DR. ANDRE GRAY |
| Credential | M.D. |
| Practice Address |
264 W 118th St Renassiance Health Care Network New York NY 10026-1620 |
| Practice Telephone | 2129326500 |
| Practice Fax Number | 2129326599 |
| Mailing Telephone | 2129326500 |
| Mailing Fax Number | 2129326599 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2013-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 183790 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01210402 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174158208 | Andre Gray | Behavior Technician | 3235 S Eastern Ave, Las Vegas, NV 89169-3310 | 2020-03-09 |
| Street Address |
264 W 118TH ST RENASSIANCE HEALTH CARE NETWORK |
| City | NEW YORK |
| State | NY |
| Zip Code | 10026-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871544536 | Dominique M Shaw | Obstetrics & Gynecology | 264 W 118th St, New York, NY 10026-1620 | 2006-05-15 |
| 1033757539 | Kiana Chindy Joseph | Nurse Practitioner | 264 W 118th St, New York, NY 10026-1620 | 2019-12-15 |
| 1073176376 | Danielle Davis | Nutritionist | 264 W 118th St, New York, NY 10026-1620 | 2019-04-22 |
| 1598290058 | Thomas J Richardson | Pediatrics | 264 W 118th St, New York, NY 10026-1620 | 2017-04-21 |
| 1417364506 | Desta Arnold | Dietitian, Registered | 264 W 118th St, New York, NY 10026-1620 | 2014-07-21 |
| 1265756647 | Oluwadamilare Adeosun | Registered Nurse | 264 W 118th St, New York, NY 10026-1620 | 2010-03-15 |
| 1932366283 | Adia N Ravenell | Physician Assistant | 264 W 118th St, New York, NY 10026 | 2008-05-22 |
| 1568590669 | Tracey Monique Blake-dixon | Physician Assistant | 264 W 118th St, New York, NY 10026-1620 | 2007-03-01 |
| 1902951080 | Mary Pegues | Physician Assistant | 264 W 118th St, New York, NY 10026-1620 | 2007-01-25 |
| 1538224811 | Lawrence Bailey | Dentist | 264 W 118th St, Second Floor Dental Clinic, New York, NY 10026-1620 | 2006-12-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538704663 | Glenda Murdaugh | Social Worker | 130 Lenox Avenue, Apt. 613, New York, NY 10026 | 2019-11-13 |
| 1043702574 | Gwendolyn Miller | Counselor | Create Inc, 73-75 Lenox Ave, New York, NY 10026 | 2018-05-31 |
| 1013423391 | Herman L Jackson | Physical Therapy Assistant | Physical Therapy of Harlem 1400 5th Ave, New York City, NY 10026 | 2017-12-21 |
| 1497264915 | Yudith O. Mahon | Registered Nurse | 110 West 114th Street Apt. 1b, New York, NY 10026 | 2017-09-27 |
| 1124546254 | Carmen Raina Abagail Lalonde | Psychologist | 155 West 72nd Street, Suite 505, Manhattan, NY 10026 | 2017-09-09 |
| 1972053387 | Crate | Community/Behavioral Health | 73 Lenox Avenue, New York, NY 10026 | 2016-10-10 |
| 1770931875 | Wendy P Nick | Speech-Language Pathologist | 240 W 113th St, New York, NY 10026 | 2016-05-30 |
| 1720464209 | Barbara D. Leese | Social Worker | 305 W 118th St, New York, NY 10026 | 2015-08-06 |
| 1982091880 | Philip Miller I | Counselor | 121 West 111th Street, New York, NY 10026 | 2015-04-20 |
| 1154711612 | Create, Inc. | Substance Abuse Rehabilitation Facility | 121-123 West 111th Street, New York, NY 10026 | 2015-02-04 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203378 | Private Medical New York, PC | Pediatrics | 110 E 60th St # 808, New York, NY 10022-1688 | 2019-09-04 |
| 1205482452 | Manhattan Valley Pediatrics | Pediatrics | 2637 Broadway, New York, NY 10025-5022 | 2019-08-14 |
| 1891349122 | Amal Khidir | Pediatrics | 445 E 69th St Rm 432, New York, NY 10021-5602 | 2019-07-25 |
| 1154888766 | Amy Leung | Pediatrics | 139 Centre St Ste 314, New York, NY 10013-4554 | 2019-03-01 |
| 1699288795 | Amaranth Pediatric Health, PC | Pediatrics | 210 Canal St Rm 305, New York, NY 10013-4186 | 2017-11-10 |
| 1356862817 | Saroj Choudhary | Pediatrics | 234 E 149th St, Bronx, New York, NY 10451 | 2017-07-05 |
| 1457889487 | Dineeta Kubhar | Pediatrics | 462 1st Ave # Nbv, New York, NY 10016-9196 | 2017-06-03 |
| 1619320835 | Winston Yuen | Pediatrics | 286 South St Apt 14a, New York, NY 10002-8081 | 2016-07-22 |
| 1558714584 | Moonlight Pediatrics of Nyc, P.C. | Pediatrics | 111 W 25th St, New York, NY 10001-7243 | 2016-07-14 |
| 1992153787 | Charlyn Marie Laserna | Pediatrics | 1000 10th Ave Ste 11g, New York, NY 10019-1147 | 2016-06-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.