Provider Demographics
NPI:1619315033
Name:MURRAY, JENNIFER A (MSED)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 ROUTE17A
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921
Mailing Address - Country:US
Mailing Address - Phone:845-928-9780
Mailing Address - Fax:845-928-6290
Practice Address - Street 1:2 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917-4006
Practice Address - Country:US
Practice Address - Phone:845-928-9780
Practice Address - Fax:845-928-6290
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist