Provider Demographics
NPI:1033162888
Name:DERMADY-RAY, DEBRA JANE (RN, ANP-BC)
Entity type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:JANE
Last Name:DERMADY-RAY
Suffix:
Gender:F
Credentials:RN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUSINESS PARK CT
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-6309
Mailing Address - Country:US
Mailing Address - Phone:315-451-5400
Mailing Address - Fax:
Practice Address - Street 1:6 BUSINESS PARK CT
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6309
Practice Address - Country:US
Practice Address - Phone:315-451-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303360163WP0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
P68769Medicare UPIN
DD2408Medicare ID - Type Unspecified