Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 25MP00681400 | NJ |
Y | 111NI0900X | Internist | 25MP00681400 | NJ |
NPI | 1003567397 |
---|---|
Provider Name | Mr. Ryan Murray |
First Address | Carteret, NJ 07008-1756 |
Second Address | Passaic, NJ 07055-4860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2022 |
Last Update Date | 18/01/2022 |