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NPI Code Detail

MEDICARE: DOMINIQUE TAYLOR MUREN

MEDICARE: DOMINIQUE TAYLOR MUREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorNY-006895NY

General Provider Information

NPI Number : 1346682580
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE TAYLOR MUREN
Provider Business Mailing Address
First Line : 1235 MONTAUK HWY
Second Line :
City : MASTIC
State : NY
Zip : 11950-2917
Country : US
Telephone Number : 631-456-2979
Fax Number :
Provider Business Practice Location Address
First Line : 1235 MONTAUK HWY
Second Line :
City : MASTIC
State : NY
Zip : 11950-2917
Country : US
Telephone Number : 631-456-2979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2013
Last Update Date : 01/30/2023

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Directions to “ DOMINIQUE TAYLOR MUREN ” Practice Location

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