Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | NY |
NPI | 1003248006 |
---|---|
Provider Name | Brian Murray |
First Address | West Seneca, NY 14224-1400 |
Second Address | West Seneca, NY 14224-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2013 |
Last Update Date | 26/12/2013 |