Basic Information
| Provider Information | |||||||||
| NPI: | 1144898107 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | RICHARD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 NOTCH HILL RD | ||||||||
| Address2: | |||||||||
| City: | NORTH BRANFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064711846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034888000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 88 NOTCH HILL RD | ||||||||
| Address2: | |||||||||
| City: | NORTH BRANFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064711846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034888000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2021 | ||||||||
| LastUpdateDate: | 06/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 000408 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.