Provider Demographics
NPI:1962102095
Name:MURCRAY, CAROLYN (CPHT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MURCRAY
Suffix:
Gender:
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT HENRY
Mailing Address - State:NY
Mailing Address - Zip Code:12974-1339
Mailing Address - Country:US
Mailing Address - Phone:518-546-7244
Mailing Address - Fax:
Practice Address - Street 1:4315 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT HENRY
Practice Address - State:NY
Practice Address - Zip Code:12974-1339
Practice Address - Country:US
Practice Address - Phone:518-546-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30224414183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician