Provider Demographics
NPI:1578398921
Name:MURRAY, SUSAN T (RN, CH-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:T
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RN, CH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-3029
Mailing Address - Country:US
Mailing Address - Phone:585-519-8825
Mailing Address - Fax:
Practice Address - Street 1:21 GOODWAY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-3029
Practice Address - Country:US
Practice Address - Phone:585-519-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY653308364SH1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH1100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHolisticGroup - Single Specialty