=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114003928
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. MURRAY LAS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 56 DIAMOND SPRING RD
-----------------------------------------------------
City | DENVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07834-2725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-625-1000
-----------------------------------------------------
Fax | 973-625-9122
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 56 DIAMOND SPRING RD
-----------------------------------------------------
City | DENVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07834-2725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-625-1000
-----------------------------------------------------
Fax | 973-625-9122
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | MA40123
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------