MEDICARE: MRS. GLORIA LORETTA MURRAY CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	F000655-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194792465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GLORIA LORETTA MURRAY CNM

Provider Business Mailing Address
First Line	:	1831 EDENWALD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2222
Country	:	US
Telephone Number	:	718-324-4410
Fax Number	:	917-529-5718

Provider Business Practice Location Address
First Line	:	2847 WEBSTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-3008
Country	:	US
Telephone Number	:	718-220-3076
Fax Number	:	917-529-5718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2006
Last Update Date	:	10/21/2010

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