Provider Demographics
NPI:1518052810
Name:MURRAY, PETER A (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 443
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-0443
Mailing Address - Country:US
Mailing Address - Phone:908-813-3120
Mailing Address - Fax:908-684-0228
Practice Address - Street 1:108 HIGH STREET
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-0443
Practice Address - Country:US
Practice Address - Phone:908-813-3120
Practice Address - Fax:908-684-0228
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC004352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
223280724OtherTAX ID NUMBER
U41389Medicare UPIN
223280724OtherTAX ID NUMBER