Provider Demographics
NPI:1811524978
Name:MURRAY, PATRICIA R (OT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:MURRAY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 GROVE PL
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-6436
Mailing Address - Country:US
Mailing Address - Phone:203-606-2405
Mailing Address - Fax:
Practice Address - Street 1:99 GROVE PL
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-6436
Practice Address - Country:US
Practice Address - Phone:203-606-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1407225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist