Healthcare Provider Details
I. General information
NPI: 1588169429
Provider Name (Legal Business Name): DANIEL PHILIP MURRAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2018
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
650 FROM RD STE 420
PARAMUS NJ
07652
US
IV. Provider business mailing address
331 NEWMAN SPRINGS RD BLDG 2, STE 220
RED BANK NJ
07701-5688
US
V. Phone/Fax
- Phone: 201-639-6620
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0004X |
| Taxonomy | Orthopaedic Foot and Ankle Surgery Physician |
| License Number | 25MA12300200 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 25MA12300200 |
| License Number State | NJ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 118412900 |
| Identifier Type | MEDICAID |
| Identifier State | FL |
| Identifier Issuer | Florida Medicaid Provider ID |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: