Healthcare Provider Details

I. General information

NPI: 1710437751
Provider Name (Legal Business Name): MISS JENNIFER L MURMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 ROUTE 6
CARMEL NY
10512-2356
US

IV. Provider business mailing address

1808 ROUTE 6
CARMEL NY
10512-2356
US

V. Phone/Fax

Practice location:
  • Phone: 845-225-2700
  • Fax: 845-225-2977
Mailing address:
  • Phone: 845-225-2700
  • Fax: 845-225-2977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: