Basic Information
| Provider Information | |||||||||
| NPI: | 1003862897 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SPINARIS | ||||||||
| OtherFirstName: | TONI | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 600 HARLEM RD | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142241151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163322121 | ||||||||
| FaxNumber: | 7163322122 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 HARLEM RD | ||||||||
| Address2: | |||||||||
| City: | WEST SENECA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142241151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163322121 | ||||||||
| FaxNumber: | 7163322122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 12/21/2015 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 188967 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 188967 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 2399862 | 01 | NY | GHI ,NY | OTHER | 000524228002 | 01 | NY | BC/BS WESTERN, NY | OTHER | 00010201102 | 01 | NY | UNIVERA HEALTHCARE HMO | OTHER | 2208450 | 01 | NY | INDEPENDENT HEATH HMO | OTHER | 01574336 | 05 | NY | MEDICAID |