Provider Demographics
NPI:1164586632
Name:SAUCIER, MURRAY JOHN JR (PT)
Entity Type:Individual
Prefix:MR
First Name:MURRAY
Middle Name:JOHN
Last Name:SAUCIER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1808
Mailing Address - Country:US
Mailing Address - Phone:315-475-9624
Mailing Address - Fax:315-701-0450
Practice Address - Street 1:1001 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1808
Practice Address - Country:US
Practice Address - Phone:315-475-9624
Practice Address - Fax:315-701-0450
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY354007OtherMVP
NY4226866OtherAETNA
NY4226866OtherAETNA
NY354007OtherMVP