MEDICARE: MRS. ANNETTE HARRIS MURRAY MSW,LSW

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	104100000X	Social Worker	SW005245E	PA

General Provider Information

NPI Number	:	1841597093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNETTE HARRIS MURRAY MSW,LSW

Provider Business Mailing Address
First Line	:	1500 N 57TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-3809
Country	:	US
Telephone Number	:	215-570-1514
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 CARPENTER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2110
Country	:	US
Telephone Number	:	215-923-2690
Fax Number	:

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

Provider Enumeration Date	:	02/24/2011
Last Update Date	:	02/24/2011

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