Provider Demographics
NPI:1063496271
Name:MURAKATA, LINDA ANN (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:MURAKATA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ELM PL
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1307
Mailing Address - Country:US
Mailing Address - Phone:856-334-5000
Mailing Address - Fax:
Practice Address - Street 1:23 ELM PL
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1307
Practice Address - Country:US
Practice Address - Phone:856-334-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01210207ZP0102X
NJ25MA04870800207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ155888BL3OtherMEDICARE