Provider Demographics
NPI:1154556264
Name:MURATA, PAUL HIROTSUNE (MED, ATC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:HIROTSUNE
Last Name:MURATA
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 PHARMACY AVENUE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M1R 2H2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 PHARMACY AVENUE
Practice Address - Street 2:SUITE 401
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M1R 2H2
Practice Address - Country:CA
Practice Address - Phone:647-802-8902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0031682255A2300X
VA01260013592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer