Provider Demographics
NPI:1265839005
Name:BARON-MURRAY, EDENA OLIVE
Entity Type:Individual
Prefix:MS
First Name:EDENA
Middle Name:OLIVE
Last Name:BARON-MURRAY
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 1:183 VAN BUREN ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-1911
Mailing Address - Country:US
Mailing Address - Phone:917-749-6188
Mailing Address - Fax:
Practice Address - Street 1:183 VAN BUREN ST
Practice Address - Street 2:APT. 4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1911
Practice Address - Country:US
Practice Address - Phone:917-749-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst