Provider Demographics
NPI:1790557528
Name:MURAS, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MURAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6932 64TH ST # 1
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5248
Mailing Address - Country:US
Mailing Address - Phone:347-628-7984
Mailing Address - Fax:
Practice Address - Street 1:6932 64TH ST # 1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-5248
Practice Address - Country:US
Practice Address - Phone:347-628-7984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1758662231252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency