Provider Demographics
NPI:1760555197
Name:MURAK, JOHN LAWRENCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LAWRENCE
Last Name:MURAK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DARWIN DR
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4804
Mailing Address - Country:US
Mailing Address - Phone:716-839-6568
Mailing Address - Fax:
Practice Address - Street 1:1185 SWEET HOME RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1018
Practice Address - Country:US
Practice Address - Phone:716-689-3471
Practice Address - Fax:716-689-3472
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020-044551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist