Provider Demographics
NPI:1023098175
Name:CYRUS A MURRAY MD
Entity type:Organization
Organization Name:CYRUS A MURRAY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-282-0100
Mailing Address - Street 1:PO BOX 250142
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-0142
Mailing Address - Country:US
Mailing Address - Phone:718-282-0100
Mailing Address - Fax:
Practice Address - Street 1:1917 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-5306
Practice Address - Country:US
Practice Address - Phone:718-282-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00906854Medicaid
NY72F221Medicare ID - Type Unspecified
NYE69915Medicare UPIN