Basic Information
Provider Information
NPI: 1225576853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURRAY
FirstName: COLLEEN
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 41 MALL RD LAHEY HOSPITAL & MEDICAL CENTER
Address2:  
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448000
FaxNumber: 7817445641
Practice Location
Address1: 8 PROSPECT ST
Address2:  
City: NASHUA
State: NH
PostalCode: 030603925
CountryCode: US
TelephoneNumber: 6035772045
FaxNumber: 6035775644
Other Information
ProviderEnumerationDate: 02/02/2017
LastUpdateDate: 10/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA7160MAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000X1242NHN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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