Provider Demographics
NPI:1194223057
Name:MURAT, KEVIN NELSON (DC, ATC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:NELSON
Last Name:MURAT
Suffix:
Gender:M
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2289 BEDFORD ST UNIT D7
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3911
Mailing Address - Country:US
Mailing Address - Phone:203-816-7073
Mailing Address - Fax:
Practice Address - Street 1:75 SELLECK ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-7207
Practice Address - Country:US
Practice Address - Phone:203-149-6356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2185111N00000X
CT0010662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No111N00000XChiropractic ProvidersChiropractor