Healthcare Provider Details

I. General information

NPI: 1477180859
Provider Name (Legal Business Name): MATTHEW MURRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVENUE BOX SURG
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

1086 1ST AVE
HELLERTOWN PA
18055-1517
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2723
  • Fax:
Mailing address:
  • Phone: 516-848-3059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number36678
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: