Gray, Jason

Gray, Jason is an individual health care provider with primary practice located at 33 Bullet Hill Rd Ste 216 , Southbury CT 06488-4699. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Gray, Jason can be contacted via phone (203) 673-1099.

Contact Information

Primary practice address
33 Bullet Hill Rd Ste 216 Southbury CT 06488-4699
Phone: (203) 673-1099
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 001368 Connecticut

Profile Details

NPI number 1164874475
LBN Legal business name Gray, Jason
Credentials LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2016
Last updated Aug 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164874475 NPPES
Connecticut MEDICAID 1164874475

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