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General NPI Number Information
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NPI Number | 1053045377
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Entity Type | Individual
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Provider Name | MAYA MURRAY OD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 10690 FAIRFAX BLVD
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City | FAIRFAX
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State | VA
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Zip | 22030-4321
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Country | US
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Telephone | 703-273-6323
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Fax |
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Provider Business Mailing Address
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Address Line | 125 S HARRISON ST APT 3A
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City | EAST ORANGE
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State | NJ
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Zip | 07018-1605
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Country | US
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Telephone | 908-448-7547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00713200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009538
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618003152
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License Number State | VA
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