Provider Demographics
NPI:1770170243
Name:MURRAY-BARRY, SANARTA ARNELL
Entity type:Individual
Prefix:
First Name:SANARTA
Middle Name:ARNELL
Last Name:MURRAY-BARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 INDEPENDENCE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4237
Mailing Address - Country:US
Mailing Address - Phone:718-419-6468
Mailing Address - Fax:
Practice Address - Street 1:5400 CRESTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2712
Practice Address - Country:US
Practice Address - Phone:718-419-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD261989977Medicaid