Provider Demographics
NPI:1063409415
Name:BUTLER-MURPHY, MARILYN STEPHANIE (DPM)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:STEPHANIE
Last Name:BUTLER-MURPHY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:MARILYN
Other - Middle Name:STEPHANIE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:849 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2842
Mailing Address - Country:US
Mailing Address - Phone:516-627-2724
Mailing Address - Fax:516-627-2749
Practice Address - Street 1:849 PARK AVE
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2842
Practice Address - Country:US
Practice Address - Phone:516-627-2724
Practice Address - Fax:516-627-2749
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003394213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0083750OtherGHI
NY155362OtherUHC
NY204408OtherPHS
NY34259OtherORTHONET
NY20105OtherMAGNACARE
NYP37162OtherBLUR CROSS BLUE SHIELD
NY00842815Medicaid
NY6938512-004OtherCIGNA
NYDS157OtherOXFORD
NYP3716OtherWELL CHOICE
NY0004452036OtherAETNA
NY155362OtherUHC
NYDS157OtherOXFORD