Provider Demographics
NPI:1366897654
Name:MURRAY, BRIAN (BS, HIS)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MURRAY
Suffix:
Gender:M
Credentials:BS, HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 VANKIRK RD
Mailing Address - Street 2:
Mailing Address - City:NEWFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14867-8901
Mailing Address - Country:US
Mailing Address - Phone:607-342-7346
Mailing Address - Fax:
Practice Address - Street 1:277 TOMPKINS ST
Practice Address - Street 2:SUITE C
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-3453
Practice Address - Country:US
Practice Address - Phone:607-753-1056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000047544237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist