1922524768 NPI number — MELANIE MURPHY ACUPUNCTURE P.C.

Table of content: (NPI 1922524768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922524768 NPI number — MELANIE MURPHY ACUPUNCTURE P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MELANIE MURPHY ACUPUNCTURE P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922524768
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 528
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SMITHTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11787-0528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-319-9424
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
811 W JERICHO TPKE STE 203E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMITHTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11787-3220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-319-9424
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
MELANIE
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
631-319-9424

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  003741 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225700000X , with the licence number: 017811 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FW97438Y , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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