Provider Demographics
NPI:1245537745
Name:MURRAY, A VICTOR III (LPN)
Entity type:Individual
Prefix:
First Name:A
Middle Name:VICTOR
Last Name:MURRAY
Suffix:III
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6320
Mailing Address - Country:US
Mailing Address - Phone:732-988-3078
Mailing Address - Fax:732-988-3078
Practice Address - Street 1:1226 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6320
Practice Address - Country:US
Practice Address - Phone:732-988-3078
Practice Address - Fax:732-988-3078
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP04986300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse