Basic Information
| Provider Information | |||||||||
| NPI: | 1306134721 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURAKAMI | ||||||||
| FirstName: | NORIYUKI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 EAST 210TH ST | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185792500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 305 EAST 16ST STREET | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185792500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2011 | ||||||||
| LastUpdateDate: | 02/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 270548 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD23128 | ME | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | NY | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | MD197490 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 03624857 | 05 | NY | MEDICAID |