Provider Demographics
NPI:1063863926
Name:MURRAY, INDIA (MSW)
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BUSHWICK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1422
Mailing Address - Country:US
Mailing Address - Phone:347-770-9911
Mailing Address - Fax:347-915-0686
Practice Address - Street 1:1420 BUSHWICK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1422
Practice Address - Country:US
Practice Address - Phone:347-770-9911
Practice Address - Fax:347-915-0686
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095408-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker