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Keriann Nickola Gray, MD
Student in an Organized Health Care Education/Training Program in State College, Pennsylvania
NPI 1023215670

Keriann Nickola Gray is a Student in an Organized Health Care Education/Training Program based in Albany, PA. Keriann Nickola Gray practices in State College, PA and has the professional credentials of MD. The NPI Number for Keriann Nickola Gray is 1023215670 and holds a License No. MD456589 (Pennsylvania).

The current practice location address for Keriann Nickola Gray is 200 Scenery Dr., State College, PA and can be reached out via phone at 814-231-4560 and via fax at 814-231-6246. You can also correspond with Keriann Nickola Gray through the mailing address at PO BOX 14890, ALBANY, NY - 12212-4890 (mailing address contact number: 518-525-5634).

Location: 200 Scenery Dr., State College, PA, 12212-4890
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023215670
Provider Name
Keriann Nickola Gray
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
200 Scenery Dr., State College, PA, 12212-4890
Phone Number
814-231-4560
Fax Number
814-231-6246
Provider Enumeration Date
06/28/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
464500 01 PA MEDICARE
institution
Provider Business Practice Location Address Details
Address
200 Scenery Dr.
City
State College
State
Pennsylvania
Zip
16801-5602
Phone Number
814-231-4560
Fax Number
814-231-6246
person
Provider Business Mailing Address Details
Address
Po Box 14890
City
Albany
State
New York
Zip
12212-4890
Phone Number
518-525-5634
Fax Number
518-649-4094
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Hematology & Oncology
Taxonomy
207RH0003X
License No.
246232 (New York)
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
MD456589 (Pennsylvania)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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