Provider Demographics
NPI:1215266515
Name:MURPHY, JUDITH (NP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2900
Mailing Address - Country:US
Mailing Address - Phone:631-979-6466
Mailing Address - Fax:631-979-6475
Practice Address - Street 1:300 E MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2900
Practice Address - Country:US
Practice Address - Phone:631-979-6466
Practice Address - Fax:631-979-6475
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381233-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics