Provider Demographics
NPI:1104140870
Name:MURRAY, EILEEN M (PT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FOXHUNT CRES
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-1708
Mailing Address - Country:US
Mailing Address - Phone:516-922-2627
Mailing Address - Fax:
Practice Address - Street 1:250 FOXHUNT CRES
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-1708
Practice Address - Country:US
Practice Address - Phone:516-922-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013659-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist