Provider Demographics
NPI:1356572630
Name:CHS MEDICAL
Entity type:Organization
Organization Name:CHS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:EIBHLIS
Authorized Official - Middle Name:JUDITH
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:914-235-8224
Mailing Address - Street 1:11 WALL ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-1905
Mailing Address - Country:US
Mailing Address - Phone:212-656-5407
Mailing Address - Fax:212-656-5121
Practice Address - Street 1:11 WALL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-1905
Practice Address - Country:US
Practice Address - Phone:212-656-5407
Practice Address - Fax:212-656-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335795261QC1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health