Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 12.007701 | CT |
NPI | 1013403849 |
---|---|
Provider Name | Mr. Devin Patrick Pray |
First Address | West Haven, CT 06516-2770 |
Second Address | West Haven, CT 06516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2018 |
Last Update Date | 18/07/2018 |