Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC00433400 | NJ |
N | 102L00000X | Psychologist | 019925-1 | NY |
N | 103T00000X | Psychologist | 019925-1 | NY |
NPI | 1013285782 |
---|---|
Provider Name | Dr. Raymond Brock-Murray |
First Address | Hoboken, NJ 07030-5610 |
Second Address | Hoboken, NJ 07030-5610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2011 |
Last Update Date | 25/02/2013 |