Provider Demographics
NPI:1578755724
Name:MURRAY, JUSTIN M (PT)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:231 WALTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-1230
Mailing Address - Country:US
Mailing Address - Phone:315-478-0380
Mailing Address - Fax:315-478-0388
Practice Address - Street 1:8112 ROUTE 12 HINGE CENTER
Practice Address - Street 2:SUITE 1
Practice Address - City:BARNEVELD
Practice Address - State:NY
Practice Address - Zip Code:13304
Practice Address - Country:US
Practice Address - Phone:315-896-4330
Practice Address - Fax:315-896-4331
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2008-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY029577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB5695Medicare PIN
NYRB5694Medicare PIN