Provider Demographics
NPI:1730563388
Name:RAY, ASHLEY (PA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:121 EVERETT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1447
Mailing Address - Country:US
Mailing Address - Phone:518-489-2663
Mailing Address - Fax:518-489-2633
Practice Address - Street 1:5 CARE LN STE 100
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8623
Practice Address - Country:US
Practice Address - Phone:518-439-8077
Practice Address - Fax:518-439-8070
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2019-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY018772363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04212740Medicaid
NYJ400240970Medicare PIN