Provider Demographics
NPI:1912152455
Name:MURRY, LAURA H
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:H
Last Name:MURRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STETSON PLACE
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751
Mailing Address - Country:US
Mailing Address - Phone:732-972-7447
Mailing Address - Fax:732-972-3539
Practice Address - Street 1:329 NORWAY AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-987-9400
Practice Address - Fax:718-987-4766
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005633-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist