Provider Demographics
NPI:1417991951
Name:MURPHY-HORNER, KELLY ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:MURPHY-HORNER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MONTAUK HWY 112
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4429
Mailing Address - Country:US
Mailing Address - Phone:631-321-7107
Mailing Address - Fax:631-321-7108
Practice Address - Street 1:1563 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1322
Practice Address - Country:US
Practice Address - Phone:631-563-3162
Practice Address - Fax:631-563-3185
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016553103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist