Provider Demographics
NPI:1366635211
Name:RACHEL MURAD
Entity Type:Organization
Organization Name:RACHEL MURAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-371-0246
Mailing Address - Street 1:1789 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2438
Mailing Address - Country:US
Mailing Address - Phone:518-371-0246
Mailing Address - Fax:518-383-9888
Practice Address - Street 1:1789 ROUTE 9
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-2438
Practice Address - Country:US
Practice Address - Phone:518-371-0246
Practice Address - Fax:518-383-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6910-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1172880001OtherDME SUPPLIER
NY1172880001Medicare NSC