Provider Demographics
NPI:1235679119
Name:MURAT, INDIA
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:MURAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LINCOLN ST
Mailing Address - Street 2:UNIT 3C
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3001
Mailing Address - Country:US
Mailing Address - Phone:857-222-9046
Mailing Address - Fax:
Practice Address - Street 1:3 LINCOLN ST
Practice Address - Street 2:UNIT 3C
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3001
Practice Address - Country:US
Practice Address - Phone:857-222-9046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9155225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist