Provider Demographics
NPI:1891726980
Name:MURRAY, CHERYL LYN (PA-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LYN
Other - Last Name:HEINTZELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1000 ASYLUM AVENUE-SUITE 3220
Mailing Address - Street 2:PAUL MURRAY, MD, LLC
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-247-3279
Mailing Address - Fax:860-727-9540
Practice Address - Street 1:1000 ASYLUM AVENUE
Practice Address - Street 2:SUITE 3220
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-247-3279
Practice Address - Fax:860-727-9540
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001866363A00000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC5-0000401OtherLICENSE
CT001866OtherLICENSE