Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | F3052 | TX |
Y | 207RH0000X | Hematologist | MD430294 | PA |
NPI | 1144333097 |
---|---|
Provider Name | Dr. Paul Francis Bray |
First Address | Philadelphia, PA 19107-4310 |
Second Address | Philadelphia, PA 19107-4310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 25/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001481640 | (05) | PA |
0120120 | (05) | NJ |
083041100 | (05) | MD |
A37101 | (02) |