Provider Demographics
NPI:1629213848
Name:MURRAY, RALPH ELIJAH (OD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:ELIJAH
Last Name:MURRAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 E FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5005
Mailing Address - Country:US
Mailing Address - Phone:718-660-2020
Mailing Address - Fax:
Practice Address - Street 1:390 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5005
Practice Address - Country:US
Practice Address - Phone:718-660-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2020-10-13
Deactivation Date:2016-05-04
Deactivation Code:
Reactivation Date:2016-06-23
Provider Licenses
StateLicense IDTaxonomies
NYTUV007123-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist