Provider Demographics
NPI:1992926521
Name:MURRAY, PATRICIA A (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 GRAND AVENUE
Mailing Address - Street 2:APT. U1
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1892
Mailing Address - Country:US
Mailing Address - Phone:516-410-7657
Mailing Address - Fax:
Practice Address - Street 1:1600 GRAND AVENUE
Practice Address - Street 2:APT. U1
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1892
Practice Address - Country:US
Practice Address - Phone:516-377-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012021-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist