Provider Demographics
NPI:1679738868
Name:GRAY-KARAGRIGORIOU, ELIZABETH RUTH (AUD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RUTH
Last Name:GRAY-KARAGRIGORIOU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:RUTH
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:800-328-8602
Mailing Address - Fax:
Practice Address - Street 1:295 BUCK RD
Practice Address - Street 2:SUITE 107
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-1733
Practice Address - Country:US
Practice Address - Phone:215-310-5915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006039237600000X, 231H00000X
PA237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA142710YAUROtherMEDICARE