Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Deionte Taun Harrilla-Gray, PA-C

Individual provider Physician Assistant · NPI 1679348205

Deionte Taun Harrilla-Gray, PA-C is a Physician Assistant in Philadelphia, Pennsylvania. Licensed in New York and Pennsylvania. Registered with an NPI since 2023.

Licensed in
NY, PA
In the registry since
2023
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone: (215) 684-5344
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence OA006887 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 031202 (NY)
Physician Assistant Taxonomy 363A00000X · Licence MA065666 (PA)

Record details

NPI number1679348205
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 27, 2023
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024

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