Healthcare Provider Details

I. General information

NPI: 1285198606
Provider Name (Legal Business Name): JAYE MURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 W BOSTON POST RD
MAMARONECK NY
10543-3605
US

IV. Provider business mailing address

1273 NORTH AVE APT 3B2
NEW ROCHELLE NY
10804-2760
US

V. Phone/Fax

Practice location:
  • Phone: 914-772-4279
  • Fax:
Mailing address:
  • Phone: 914-772-4279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR045825-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: