Healthcare Provider Details

I. General information

NPI: 1164744256
Provider Name (Legal Business Name): AUDREY MURRAY M.D,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMUNITY DR 4 LEVITT, DEPT OF OBSTETRICS AND GYNECOLOGY
MANHASSET NY
11030-3816
US

IV. Provider business mailing address

300 COMMUNITY DR 4 LEVITT, DEPT OF OBSTETRICS AND GYNECOLOGY
MANHASSET NY
11030-3816
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-4435
  • Fax:
Mailing address:
  • Phone: 516-562-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number256608
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: